Why You Shouldn’t Let Sleeping Babies Lie (Pedcast)

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So, you are coming home from the hospital with your newborn.  You’re a little on the tired side…No, you’re exhausted.  Everyone in a hospital wants you to deal with him or her on their terms.  Always waking you up.  Telephone, friends coming by.  Finally, you’re home in your bed, your house…some sleep!

 

You’re thinking, “My baby is quiet, doesn’t demand much, sleeps a lot.  I HAVE A GREAT BABY.”  You’re hoping that maybe the quiet bliss will continue.  You need to decide, “Now that I am home, I will let him or her set their own schedule.”  Is that a good idea the first week home?  In today’s pedcast, we are going to explore the question of whether babies need to be awakened for feeds in the first week of life.  “What’s wrong with letting my baby demand feed in the first week of life…they know when they are hungry, right?”

 

 

 

Let’s back up and look at life from your baby’s perspective. In the womb, babies are fed continuously; they are never hungry or thirsty.  YOUR BABY HAS NEVER EXPERIENCED HUNGER OR THIRST AND MAY NOT KNOW WHAT TO DO WITH THAT FEELING!  BABIES HAVE NO REPONSIBILITIES IN THE WOMB!  “Life is good man.  I can’t mess up.”

 

 

 

Now your baby is born, after a long and strenuous process.  If your baby could talk in the first 2 days of life, they probably would say something like, “Wow I have a headache.  I am so tired.  Just leave me alone.  I just want things to be quiet and stop undressing me, I hate that.  And while you’re at it, turn down those lights and tell Junior next to me to stop crying.  I suck so much and I only get a few drops of milk.  Sucking is fun but not very rewarding.  No mind, I’m not very hungry anyway, since I was born with plenty of extra water in my body.”

 

Now your baby is 3-4 days old, and his or her thinking has changed: “Something is not right.  I have this uncomfortable feeling.  I’m hungry and thirsty…never been there before.”  As they say around NC, time for your baby to fish or cut bait.  Time to separate the men from the boys, the divas from the wallflowers.  Most babies at this point become demanding, scream until they are fed, and quickly learn how to deal with the hunger feeling…but not all.  Some babies are still very sleepy from delivery and simply don’t respond to this new feeling…hunger.  They just sleep.  They remain dopy and lethargic.  These sleepy babies can get into serious trouble with dehydration and jaundice because they have had very little intake for days, they have used up their reserve, and their tanks are on empty.  They can get very weak.  Poor parents can be thinking that everything is OK since junior isn’t demanding feeds

 

One moment, I see a question coming in from Ireland:

 

“Doc Smo,  Marge McCracken from Ireland here.  My little ______ sleeps all the time.  How do I know if they are one of those sleepy babies you talk about?”

 

I’m glad you asked, Marge.  The sleepy babies, unless woken up every 3 hours, can get into serious trouble with dehydration and jaundice.  As your baby’s jaundice builds, so will his or her  sleepiness.  Here are some signs your baby may be getting into trouble:

 

  • Wet diapers are not coming every 4-6 hours, may be dehydrated, leads  to weakness
  • Your baby is getting more yellow…i.e. jaundiced, also makes them sleepy
  • Your baby’s poop has not changed from its initial black color to a yellow, green or brown color by the 4thday of life: this is a sign that milk is not getting through
  • Finally, your baby has lost more than 10% of their birth weight; this is a clear sign of trouble

 

Marge again.  What are your recommendations for parents as far as feeding in the first week home?”

Here is what I recommend, Marge:

 

  • Wake every 3 hours from the beginning of one feed to beginning of the next
  • Try to get your baby checked as close to the 4th day as possible
  • Be extra careful if your baby born on Thursday…4th day is Sunday
  • If you have a preemie (that is, less than 37 weeks), be extra careful. They can have trouble with the simplest things.
  • Look for wets every 4 hours.  Lack of urine should alarm you.
  • Poop should turn golden by the 4th day of life…If it does not, that should be cause for alarm.

 

Bottom line, lack of stool and urine in a sleepy baby who is difficult to feed could mean trouble.  Call your pediatrician for help.

 

This is Dr. Paul Smolen, broadcasting from famous Studio 1E in Charlotte, NC, the Queen City.  Visit Doc Smo on Facebook, Twitter, iTunes, or my website, Docsmo.com.  If you have a comment, feel free to share your thoughts…that’s what blogs are all about!  This is Doc Smo, hoping if you have a new little squirt, that they stay well fed and alert.

 

Until next time.

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Milk Transition-When, Why, and How (Pedcast)

 

 

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Transcript: “Milk Transition, When, Why, and How”

 

Transcript:

Welcome to another edition of DocSmo.com

 

Thanks for joining me today, I am your host, Dr. Paul Smolen.

 

Frequently asked question by parents about the composition of milk and can they stop buying formula.

 

Parents anxious to change to whole milk because of convenience and cost.

 

To understand, need to know some immunology and chemistry.

 

While we are at it, let me give you some practical advice about making the change from baby milk to big people milk.

 

How do breast milk, cows milk based formula, and whole cow milk differ? To answer lets detour down science lane.

 

Compared with breast milk and formula, whole cows milk has less sugar…not as tasty…naturally some resistance by junior.

 

Compared with breast milk  and formula, whole cows milk has more protein and thicker, less soluble proteins…more curds…slower transit, more fermentation into cheese , therefore harder stools for little Janie or Johnny.

 

Compared with breast milk, whole cows milk has proteins that can frequently provoke allergic reactions, especially children under 6 months.  The allergic reaction in the gut can cause bleeding gut wall.  Subsequent anemia can develop and anemia in first year really bad associated with various serious health issues. That’s why we don’t give whole cow’s milk  to babies under 1 year!

 

Compared with breast milk and formula, whole cow’s milk has almost no iron, which as you know, is a vital nutrient for children.

 

Compared with breast milk and formula, whole cow’s milk is missing some fats and vitamins that others have but solids should make up for this.

 

When milk is the whole ballgame, early infancy, we need to get it right.

 

In the second year, not as important because of so many other nutrients and much of brain development has already occurred.

 

The bottom line is that whole cow’s milk is not appropriate food for infants( children in the first year).  I repeat, whole cow’s milk is not appropriate food for infants.

 

 

 

Time for a call in question from Boris: ”What do the experts recommend for my little comrades?”

 

Their recommendation is a strong one: breast milk or formula until at least one year.  Remember, those Doc Smo pearls, “Breast is best” and “Longer means stronger” and “Mom is de-bomb.”

But all good things come to an end. At some point must give up the breast.

 

When you do transition, make sure you go to whole milk, which is about 5% fat.  Nothing leaner; not 2%, not skim.  This is because your child’s brain is made of fat and consumption of fat is essential for proper brain development.

 

Most parents transition to whole cow’s milk at around 1 year but not all.  Many cultures breast feed long into childhood.  Nothing wrong with that. Cultures evolve and change.  50 years ago almost no one breastfed in the US. Science is overwhelming that breast milk is the best food for babies.  Maybe we are headed for a cultural change, longer breast-feeding with a delay in weaning?

 

What kind of problems do parents experience when transitioning to whole cow’s milk?

 

1. Not as sweet.  Baby may refuse since whole cow’s milk is not as sweet as breast milk or formula. I recommend you mix the whole cow’s milk with formula or breast milk and slowly wean your child away from the sweet taste.

 

2. More protein and different proteins can mean more constipation… The savvy parent is ready for this with more fruit, fiber, and water.

 

3. Less iron can also spell trouble. Again, the savvy parent is ready with iron rich foods. Meats (any are fine), infant cereals, green leafy veg, and dark purple fruits, raisins, plums, prunes.  These are foods all of which are rich in iron.

 

4. Whole cow’s milk like breast milk and formula may not supply your child with enough Vitamin D.  Vitamin D, 400 IU needs to be continued throughout childhood.

 

So let’s sum it all up.

 

Whole cow’s milk is not appropriate food first year, pure and simple.

 

Breast is preferred, but when it is not available, infant formula is the only substitue in the first year of life.

 

Most parents transition their children to whole cow’s milk at around 1 year to whole. Experts warn against using not leaner mil in the second year because babies at that age need a lot of fat in order to grow properly.  Whole cow’s milk is a good food for children in the second year of life but should be given along with a good variety of other nutrients given.  Milk alone is not a complete food.

 

Problems that parents may encounter when transitioning to cow’s milk are resistance to taste because not as sweet and constipation because of protein content and composition is different. To counter these problems, I recommend you reduce the sugar content slowly and make sure infant has high fiber intake during transition.

 

Many children are tired of milk from their first year. Be persistent with milk since for many children, this is an acquired taste. I feel that your child’s choices of drink during childhood should be either milk or water.  Stay away from juices and other sweetened beverages, even diluted.

 

Vitamin D supplement need to continue and limit milk intake to no more than 24 ounces per day.  And those bottles, they need to go at your child’s first birthday.

 

That’s it for this week from studio 1E, you know, the first child’s bedroom on the east side of the house.

 

Thanks for joining me.

 

Comments are welcome as always.

 

Get new content iTunes, Facebook, or my website DocSmo.com

 

Dr Paul Smolen, hoping your child’s transition to milk goes smooth as silk.

 

Until next time.

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Antiperspirant and Deodorant Facts…No Sweat! (Pedcast)

Got a smelly teen on your hands? Get the stink on the latest developments regarding antiperspirant, deodorants, and your child’s long term health.

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