1st Year Parenting Basics

Baby Led Weaning, by Rapley and Murkett (Book Review Pedcast)

Baby Led Weaning

by Rapley and Murkett

Vermilion Publishers-2008

Help support DocSmo.com by buying this reviewed book using this affiliate link. You get Amazon’s best price and DocSmo.com earns a small affiliate marketing fee.  Thank you.

Baby-Led Weaning, Completely Updated and Expanded Tenth Anniversary Edition: The Essential Guide―How to Introduce Solid Foods and Help Your Baby to Grow Up a Happy and Confident Eater

Who would have ever thought that feeding an infant solid foods, the way your great grandparents did, would be a cutting edge medical controversy in the 21st century–but it is. So says the authors of Baby Led Weaning, by  British authors Rapley and Murkett. 20th century western society has been all about controlling the introduction of solid food to babies when it is time for them to get more that breastfeeding can offer. It is generally accepted that solid foods, also called complimentary foods, are needed by babies for good growth beyond six months of age. Standard 20th century dogma says that these first foods should be pureed and fed to the infant on a spoon, by his or her parents, introducing one new food at a time, without the addition of spices, salt, or added flavoring that would be normally added to the food.  Home cooked fresh foods were the opposite of what  babies were expected to eat for much of the 20th century America.

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Baby Walkers…beware! (Pedcast)

Baby walkers are fun for infants and can be useful for parents.  They just aren’t safe!  Dr Smolen lays out the facts about these devices and encourages parents to stay away.  This is a must listen to podcast for anyone considering using an infant walker.

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Essential Info about your Baby’s Head Shape (Pedcast)

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Transcript: Essential Info about your Baby’s Head Shape (Pedcast)

-Welcome to another edition of DocSmo.com, your reliable source of information for parents about a wide range of pediatric parenting and health topics ranging from the bassinet to the boardroom.

-Thank you for joining me today.

– I am your host and the founder of DocSmo.com…Dr Paul Smolen, a board certified pediatrician with 30 years of private practice under my belt.

-These “pedcasts” are intended to bring parents useful practical information about important pediatric topics.  A supplement to your child’s regular office  visits with their health-care provider.

-This is the kind of discussion your pediatrician would like to have with you if they had unlimited time during your child’s health supervision visits.

-I want to stress that by making this podcast, I am not intending to give specific medical advice for your child, rather general information on the topic of the day which today is “What parents need to know about head shape in babies.”

 

-Parents often worry about their baby’s head shape…especially in the first year of life.

-First, we have all the consequence of the birth process… and what a process it is.

-Babies usually come head first into the birth canal, first hitting the hard bones of Mom’s pelvis, then squeezing through Mom’s cervix and vagina.

-Bruising and molding of the skull bones are almost inevitable as a consequence of these processes.

-Many parents are startled and frightened by the molding and bruising their infant is born with but rarely are these a serious concern.

-With the rapid brain and skull growth that occur in the first few months of life, the distorted shape of a newborn’s skull rapidly disappears…unless they spend so much time on their backs in monotonous positions that flattening starts to occur in the back of their little heads.

 

– The medical term for this one sided flattening is plagiocephaly and pediatricians definitely started seeing more of this deformity after the back to sleep campaign started in the US…that’s the recommendation to always have babies sleep on their backs on a safe surface whenever they are unattended.

-Not only can plagiocephaly be a cosmetic problem, but some feel that with enough asymmetry of the skull can come along vision problems since, with enough forward shift one side of the face,  one eye may be in a different plane than the other.  A similar process is thought to possibly cause jaw problems since the mandible may not fit properly on the skull if the upper face is not symmetric.

 

-Everyone agrees that flattening of one side of the skull is something that we want to avoid.

-It can persist into adult life if it is severe.

-Here is what you can do to avoid problems with your baby’s head

         -Start doing tummy time, as soon as your little bundle of joy comes home from the hospital.

         -Try and turn your infant’s head to alternating sides when you lay them down for sleep as soon as you get home from the hospital.

         -Try to get Tummy time, supervised of course, for 30-60 minutes a day on a firm, safe sleep surface…for more on that, I remind you to check out my pod cast on “Safe sleep”

         -If your child always wants to lay on the same side of their head, they probably are doing so because of a cramped womb position.  Have your pediatrician check their neck for tightening or stiffness.  Should this be present, have them show you some exercises to help alleviate this tightening or have them send you to a physical therapist for this purpose.

 

-Here are some things you should not do in an attempt to help your infant’s head shape are:

         – Let your infant sit in a car seat or any seat for that matter  for long periods of time in the same position.

         -You should not buy devices to hold your baby in a certain position to lower pressure on his or her head.  These devices are well intentioned and may work, but their safety is always a concern.  Experts recommend that they not be used.

         -When using tummy time, never leave your child unattended even for a second.

 

-It has been my experience that the flattening can be avoided if parents are proactive with Tummy time and be careful not to miss neck stiffness.

-Should the flattening occur despite your efforts, referral to an specialist in head orthotics should be made by 6 months of age.  They will help you decide if your infant needs a skull-molding helmet to reshape their head.

-These helmets are expensive and don’t always work especially if not put on by 6 months so remember the DocSmo pearl…. Prevention trumps treatment almost every time.

 

 

– I hope the new parents in my audience today found this pedcast useful.

– The head shaping helmets I referenced in the pedcast cost between $1500-$4000 in my community and are not always covered by insurance so by listening to DocSmo today, potentially I may have saved your family a significant chunk of change… all in a days work.

-If you found this and other pedcasts useful, go ahead and take the plunge.  Subscribe on itunes, like DocSmo on face book or follow us on twitter.

-Currently, all of my content is available for free at my website, www.DocSmo.com.

-And don’t forget to check out my Smo Notes posted at my website where you can find reliable reference material with a simple click of the mouse.

-As always, this is your host, Dr Paul Smolen, broadcasting from studio 1E, that’s the first child’s bedroom on the east side of the house, protecting you from the dread of having a child with a misshapen head.

 

Until next time.

Smo Notes:

Clinical Report: Prevention and Management of Positional Skull Deformities in infants, Pediatrics Volume 128, Number 6, December 2011

 

*By listening to this pedcast, you are agreeing to Doc Smo’s terms and conditions.

 

All Rights Reserved.

Teething, Just the Facts Ma’am (Pedcast)

Transcript:

Welcome to another edition of DocSmo.com, your source for mp3s about pediatric topics.  This is your host, Dr. Paul Smolen–pediatrician by day, blogger by night–on location in the Low Country.  Yes, it’s vacation time, and me and the Mrs. are enjoying the unbelievable beauty of the South Carolina coast.  Before we get into the nitty gritty of today’s talk, let me remind my new and old listeners alike that I may or may not be your child’s doctor, and that I am not giving out medical advice specific to any one child… rather, general information about pediatrics.  For specific advice about your child, you need to visit the wonderful person you call your child’s pediatrician.

 

Today’s topic: “Teething…Just the Facts, Ma’am.  We are going to explore the essential facts about teething that new parents need to know.  So let’s get started, shall we?

 

Parents really seem to begin worrying about teething when their children come for their 4 month checkup.  I hear on a daily basis, “My infant is drooling and chewing a lot, is this teething?”  I really don’t think so.  At 4 months, babies still have very limited ability to control their muscles.  The muscles they do have the most control over are those of their mouth.  Ergo…chewing and drooling.  At this age, babies usually begin cooing and laughing as well; is this from teething as well?  I don’t think so.  The fixation that young children have with mouthing objects is their way of exploring the world, not a sign of teething in my opinion.

 

When parents bring their child for the 6-9 month checkup, parents often have infants that are still needing a lot of attention at night to sustain sleep.  I hear the same teething concerns at this visit: “This teething is terrible.  My child won’t sleep, chews on everything, and drools all the time.”  I will ask, “Does pain medicine help, Mrs. Jones?”  “No, it must be terribly painful because pain meds like acetaminophen and ibuprofen don’t help. We are up all night dealing with this severe pain.”  Then I ask, “What about during the day, is teething painful then?”  “No, it just seems to be at night.”  Hmmmmm.

My opinion again…Pain meds don’t help because these infants don’t have severe pain, but rather an overdependence on their parents at bedtime.  No daytime pain because the discomfort of teething is very mild.  No response to pain meds because, again, the discomfort is mild.  The problem is much worse at night because the main problem is that the child has not learned to become independent at night yet….For more on that subject, check out “Straight Talk About Sleep in Infancy.”

 

 

So what is the science behind teething?  Does teething cause fever?  Studies say no.  Does teething cause diarrhea?  Studies says no.  Does teething cause severe pain?  Not very often in my experience.  Is drooling a sign of teething?  Not in my opinion.

Remember, two things can happen at the same time and not be related.  Parents, are always looking to make sense of things.  I respect that, but it gets them in trouble sometimes.  A child can have a severe viral illness or another source of pain like a stomach ache at the same time that they are teething, which is affecting their behavior or sleep.  Those two things may happen at the same time but be completely unrelated.  Here is the point to remember: don’t attribute high fever or severe pain or diarrhea to teething no matter what Grandma says.  There is probably something else wrong with your child, and you need to get it checked out.

 

 

I don’t mean to minimize the whole teething process; there is something going on here.  Children get teeth all through childhood, and there is some discomfort associated with the eruption of teeth, just not severe pain unless there is a dental problem like an infected tooth.  Here is what I want you to remember about teething:

 

    • Never attribute a high fever, severe diarrhea, a major sleep problem or severe pain to teething.  Get your child checked out if they have any of these symptoms.
    • The discomfort of teething can be dealt with acetaminophen or a cool (not cold) chewing toy.  Make sure it is a safe toy!
  • My experience tells me that topical numbing drops are not very useful.
  • Remember, the eruption of teeth is not a real painful process in older children, so why should it be such a problem for younger children?  Think about it.

 

 

 

Thanks for joining me for this podcast.  If you learned something and I was able to enhance your understanding of a pediatric topic, that is great.  Feel free to check out other discussions of pediatric topics by exploring my website, DocSmo.com.  Get your free pediatric education with a simple click of your finger.  A mom told me the other day that she downloaded all of my content and made her husband listen to them on the a particularly long car ride.  Dad, I am sorry for that… 73 posts to date!  Wow.  This is Dr. Paul Smolen broadcasting from the Low Country of SC, hoping you got a little schooling on your child’s drooling.

 

Until next time.

 

 

1. http://www.webhttp://www.mayoclinic.com/health/teething/

2. http://www.mayoclinic.com/health/teething/FL00102

3. http://pediatrics.about.com/od/teething/a/0107_teething.htm

 

 

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Subscribe on iTunes or follow us on Facebook and Twitter!

 

*By listening to this pedcast, you are agreeing to Doc Smo’s terms and conditions.

 

All Right’s Reserved.