Baby 411 & Toddler 411 Blog

Colic: The Unhappy Hour(s)

It's the “C word” in new parent circles. While many parents are forewarned about colic and worry that their baby might have it, many don’t even know what colic is. So, this post explains what colic is, and what (if anything) you can do about it.

Q. What is colic, anyway?

It is known as the Rule of Three’s. It starts around three weeks of age. The baby cries for about three hours straight (beginning right around “happy hour” —ironic, right?). And, it lasts until the baby is three months old. About 15% of all babies are afflicted with this malady.

Q. What causes colic?

Although scientists have been studying colic for years, no one knows exactly what causes it. Many experts think the problem is due to immaturity of the gastrointestinal or digestive system. So over the years, doctors have tried treating it with medications to reduce gas, relax the intestinal muscles, or cause sedation. None of these medications really help. The best treatment for colic is time….all babies eventually outgrow colic.

Some babies who seem “colicky” actually have a medical diagnosis. So, it is important to check in with your baby’s doctor if you've got a chronically fussy baby on your hands. Some babies have heartburn (gastroesophageal reflux disease or GERD). Those babies are usually miserable all day and night or around feedings—not just for a three hour period everyday. Other babies may have a cow’s milk protein allergy and don’t start to show signs of discomfort until several weeks of being exposed to the milk protein going through mom’s breast milk or in standard cow’s milk-based formula.

Q. What can I do to help my baby with colic?

What’s a parent to do? (Because, of course, we are all compelled to do something to help our babies feel better even when the doc tells you there is no treatment but time.) After browsing the net, you’ll no doubt find many colic treatments that make miraculous (and unregulated) claims.

My advice before starting any treatment is to ask yourself this question: Am I treating my child to make myself feel better (because I feel I am doing something), or does the therapy really work?

Q. Are there any new studies on treating colic?

A study published today in the journal, Pediatrics examines the scientific evidence supporting the most popular complementary and alternative therapies for colic. So, there isn't any breakthrough research here...it just puts this issue into perspective. Here’s what they found: Of 1764 studies done between 1991-2008, 15 were considered reasonable enough to review. Of those, only 8 of them were well designed. And here’s a key point: most of the purported treatments and effectiveness reported in a study have not been independently verified by other studies. Good science is like a good recipe—it can be repeated with the same results.

That said, let’s take a look at the therapies:

 

1. Spinal manipulation—Four studies were reviewed. Some parents reported improvement in the studies, but all the studies had methodical weaknesses. One study on chiropractic treatment showed no improvement in the number of hours a baby cried.
2. Herbal remedies—Herbs included chamomile/fennel/licorice/vervain/balm mint tea or fennel seed oil*. Three studies were reviewed. The small number of children enrolled in the studies limited the strength of the findings. But, parents noted a significant reduction in colic symptoms compared to the untreated group. Fennel is thought to work by having a relaxing (antispasmodic) effect on the gut and increasing the gut’s motility.
3. Sugar remedies—Babies were given either a glucose or sucrose* solution. Five studies were reviewed. Both sugary supplements seemed to help reduce colic symptoms.
4. Probiotics—Two studies were reviewed. In one study, one group of babies received a probiotic (L reuteri) and the other group received anti-gas drops (simethicone). 95% of parents reported improvement with the probiotic, compared to just 7% with the anti-gas drops.
5. Massage therapy—One study showed conflicting results. 93% of parents reported improvement in symptoms, yet 21% said there was no effect after the treatment itself. This calls into question if symptoms just improved with time.
6. Reflexology—There was no difference between targeted and nontargeted therapies which suggests that there is just some healing power of touch!

*More than one study found similar results.

Bottom line: None of these treatments are truly supported by the scientific evidence we have to date. More research is in order to help these babies and their parents!

Q. Given the lack of data, what do you recommend to your patients?

If everyone in the house is miserable, I suggest trying “gripe water” (a combination of ginger and fennel) or a daily dose of L. reuteri probiotics. Both products are available in pharmacies and online. I don’t make any promises, but I have seen some scientific evidence of their benefit and safety. I’d certainly like to see more research on colic, though!

Children Act Fast...So Do Poisons

Creepy title, I know. But, it's National Poison Prevention Week, Moms and Dads, and this is the morbid motto for the 2011 campaign.

Here are the sobering stats: Every year, 2.4 million people—over half under SIX years of age—swallow or come in contact with a poisonous substance.

I know, I know, this would never happen on your watch. Unfortunately, most of these accidents happen when a child is at home and the supervising adult is distracted. So, what can you do to prevent one of these potentially deadly situations?

Here are some tips from the American Academy of Pediatrics:

• Store medicine, cleaners, paints/varnishes and pesticides in their original packaging in locked cabinets or containers, out of sight and reach of children.
• Install a safety latch – that locks when you close the door – on child-accessible cabinets containing harmful products.
• Purchase and keep all medicines in containers with safety caps. Discard unused medication.
• Never refer to medicine as “candy” or another appealing name.
• Check the label each time you give a child medicine to ensure proper dosage.
• Never place poisonous products in food or drink containers.
• Keep coal, wood or kerosene stoves in safe working order.
• Maintain working smoke and carbon monoxide detectors.

Be sure to have Poison Control on speed dial. The number is 800-222-1222. Obviously, if your child has swallowed a poison and is unconscious, having a seizure, not breathing, or is lethargic or unresponsive, the phone number to call is 911. (And start CPR until EMS arrives if your child is not breathing!) But, if your child is not having any symptoms or is not showing signs of immediate distress, Poison Control gives great advice for the next steps.

Here is some practical advice for first aid in the most common poisoning situations.

• We no longer recommend making your child vomit by using syrup of ipecac. If your child has swallowed a poison and he is able to spit it out, go for it.
• If a poison has touched your child's skin, remove your child's clothing and rinse your child off with lukewarm water for 15 minutes.
• If a poison enters your child's eyes, flush her eyes with room temperature water towards the inner part of the eyes for 15 minutes (yes, that is probably very difficult to do with a young child). Do not stick your child's head under the faucet to do the rinsing. And, don't let your child rub her eyes.
  
• If your child inhales poisonous fumes, take him outside to let him breathe fresh air.

For more tips on home safety, check out safekids.org.

 

How long does your baby need to stay rear facing in a car seat?

While the safety data was released a couple of years ago, today the American Academy of Pediatrics updated its previous policy on carseats to say: Kids should stay rear-facing in a carseat in the back seat of the car until TWO years of age. Why? It's safer for a young child's head and neck support to be rear-facing. In fact, there fatality risk in a car accident goes down by 75%!

Here are some of the highlights:

• The "rear-facing until two" is a guideline only. Young children who are very small, or born prematurely, may need to stay rear facing longer--until they outgrow the weight and height limits for the rear-facing carseat. And, kids who are big may outgrow the size limitations younger than age two and may need to be turned forward-facing earlier.
• Once a child outgrows the size limits of rear-facing, he should be forward-facing in a harness carseat until he outgrows that seat.
• You can check your carseat's size limitations on the label or in the instruction manual. In general, convertible carseats are safe for rear-facing until a child weighs 35—45 lbs. Height limitations vary as well.
• Kids need to remain in booster seats until at least EIGHT years of age, or when they exceed the size limits for a booster and they are ready for a seat belt.
• Kids should not be riding in the front seat of a vehicle until they are at least 13 years old.

 

 

 

 

 

 

 

 

 

Expecting 411 author Dr Michele Hakakha on Rachael Ray Show Friday!

 

Set your DVR's for Friday's Rachael Ray Show! Our very own Dr. Michele Hakakha is in the house, testing out products that claim to relieve morning sickness. For all those preggo gals suffering from this malady, this show's for you! Check out Rachael's website to see where and when the show airs in your hometown.

Suri Cruise & Binky Addiction: When is it time to move on?

Newborns have very few skills to soothe themselves—sucking being one of them. So, it's commonplace to find an infant using a pacifier or sucking his thumb or fingers. But by 4—6 months of age, babies have other strategies to calm themselves down. And by the time babies reach their first birthdays, they are definitely ready to lose the binky and move on.

But, we've all seen kids who are much older than that clinging to their beloved binky. Case in point: Suri Cruise, who turns 5 next month. Other than this accessory clashing with her Dolce&Gabbana handbag, is there any harm in continuing to use the binky?

Yes. And that's why I am bothering to write this blog. It's not because I really care what celebrity families do. It's because MANY other parents continue to give their kids a pacifier long after they really need it and it can have some adverse health effects. Here are a few:

1. Pacifier use is a known risk factor for ear infections. Ear infections are not fun.

2. Prolonged pacifier use in preschool years and once the permanent teeth come in (around age 5) can lead to an altered bite position of the teeth or a cross bite. Can you say expensive orthodontist bills?

3. Older kids who use pacifiers also put other things in their mouths to explore them, instead of using their hands. That means more risk of germs entering the mouth and leading to infections. Also not fun.

4. Pacifier use at bedtime is a sleep crutch. Kids think they need to be sucking to fall asleep, thus they need to suck when they awaken at the end of every sleep cyle (about every 90 minutes). If the pacifier falls out, they wake up and start looking for it (or scream for a parent to come put it back in). There is a real health value in a good uninterrupted night's sleep for both child and parents. Most parents are too exhausted to get out of this vicious cycle to realize that!

I think parents allow the binky to remain in their child's life long after infancy because life just seems easier with it around. It calms and quiets the child, or it helps the child fall asleep. But the truth is, kids are much more resilient than parents give them credit for. Out of sight is out of mind. If the binky disappears, the child quickly moves on and adapts. Really! And, it only gets harder to take away as your child gets older.

Sometimes Mom and Dads need to grow up with their child!

Baby 411 exclusive interview with Uchi chef/author Tyson Cole: How to get kids to eat their veggies!

As parents we all struggle with getting our kids to eat vegetables or to branch out beyond beige food. Curious to know what an expert in the kitchen does for his or her kids? We are, too!

So, we asked Tyson Cole—James Beard nominated, Food and Wine magazine’s “Best New Chef” award winning chef /owner of Uchi and Uchiko/author of Uchi:The Cookbook and father to three young children— how he tackles this issue. Full disclosure: his professional chef wife, Rebekkah, also chimed in! What we learned: even professional chef parents can have a picky-eater child! (She doesn’t know what she’s missing. We’d be happy to eat her leftovers….)

Here is the full interview:

Q. What were the first solid foods you offering your kids when they were babies?

A. We started with organic yogurt mixed with rice and mashed in fruit.  The kids ate lots of cheesy eggs, too.  That is, except for our 10 month old, who seems to have an intolerance to anything from a cow. She likes tofu cooked in a seasoned chicken broth, peanut butter and agave toast, eggs, and all kinds of fruit.

Q. Did you make your own baby food?

A. With three kids, we are all about convenience. When we had time to prepare their baby food, we did. But, we NEVER stressed if we gave them something from a jar. We always opted for organic baby food, but we tasted it first and added whatever seasoning it needed.

Q. Did your kids protest veggies when they became toddlers? Did you just continue to offer them, sneak them in, or use any creative strategies?

A. Our oldest child is the “picky eater” in our family, although she’s getting less and less picky as she gets older.  We just kept putting veggies on her plate and told her she had to try one bite and that was all but, she had to try it every meal.  No pressure or rewards for cleaning the entire plate. And yes, I have been known to puree veggies and add them to different sauces for various dishes.

Q. What’s the secret to making veggies taste good and look appealing to a toddler?

A. Lots of colors and dips.  We’ll mix yellow or orange bell peppers with golden raisins, clementines, sunflower seeds or slivered almonds, with juice from half a lemon, grapeseed or olive oil, and sea salt.  Our kids love it!

Or, we’ll cut different crunchy veggies into sticks and serve it in a pretty glass with a citrus vinaigrette dressing for dipping (very popular).  We offer a variety of raw veggies to try.

Our kids will also eat kale, believe it or not. Kale chips are pretty easy to make. Just roast torn pieces with olive or grapeseed oil, a little salt, and any other spices that are appealing.

My best piece of advice is to be creative and think like a kid!

Q. Any other secrets or take home tips for parents?

A. Here are a few:

1. Start a veggie/herb garden even if you don’t have a lot of room. Let your children plant, tend, and harvest (with your help, of course).

2. Get your kids in the kitchen. Cook and bake with them!  Let them help be part of the creative process.  We bake several different kinds of muffins and we add our “secret” (sounds more appealing than “healthy”) ingredients.

3. Have pizza night!  Put out lots of fresh veggies, greens, herbs, cheeses, spices/seasonings, and let them go to town.

4. Have cleaned fruit and veggies out on the counter. We snack on them while we work together in the kitchen. It helps take the “eat your veggies!” pressure off when it comes time to sit down and eat.

 

Thanks for all these great tips, Tyson and Rebekkah!

Tyson Cole is the chef/owner of Uchi and Uchiko restaurants in Austin, TX.  A meal at either place is worth the trip to Austin.

His first cookbook, called Uchi: The Cookbook, is available in bookstores and online March 1.