And They Slept Happily Ever After

Sleeps Like a Baby

Why Won’t My Baby Sleep?

 

 

 

 

Guest Blogger: Tonya Sakowicz, Newborn Care Specialist

 

As a newborn care specialist and sleep trainer, I get many questions about babies from feeding to diaper changing and swaddling.  However, the most common question I get is often more complex than the inquiring parent realizes.  The question goes something like this: “I have a baby who is a few weeks old and I cannot get him to sleep anywhere except on me.  If I try to lay him down on his back like all the books say, he just screams and screams and lately it seems to be getting even worse.  What do I do?”

 

When most parents call with this question, they assume that they are facing a sleep problem.  What they don’t realize is that quite often they are dealing with much more than just a sleep problem.  With a few more questions I can target the real issue, which is usually not sleep at all.  Instead, it is their baby’s tummy, either in the form of acid reflux or food allergies and intolerances; sometimes both.  It is not always obvious that their babies are in pain, but sleeping upright on mom, dad, or nanny’s chest relieves a significant amount of the discomfort caused by acid reflux.  It also provides the kind of comfort that only comes from human touch.

 

Often these parents report babies who have been diagnosed with “colic” by their pediatrician, if they had discussed the problem with their doctor at all.  Many parents are afraid to bring their concerns to their pediatrician for fear of looking like inept parents or inadequate care givers.  However, this problem does need to be brought up, especially if the pediatrician tries to dismiss parents’ concerns, calls it “colic,” or tells them nothing can be done and they will have to tough it out until it goes away.  The medical community is discovering that “colic” has an explanation and it can be treated.  If the pediatrician cannot help resolve it, a trip to the pediatric gastroenterologist could be worthwhile.  They have the ability to diagnose and treat the pain this condition creates.  Once it is treated, parents often find their babies can sleep well on their own. 

 

There are a few things to help make the baby more comfortable in the meantime.   If using formula, try switching to a hypo-allergenic brand.  This is especially helpful if the baby vomits a lot, which could indicate a dairy allergy or intolerance and a simple switch in formula could make everyone happier.  Elevating the baby’s sleep surface 30 degrees is another tip to keep acid from coming up into the esophagus and causing the pain and discomfort.  Also, try feeding the baby in an upright position and continue to keep their torso elevated for 30-45 minutes after each feeding.  Avoid laying them flat except when you absolutely must.  These few tricks can really help and make the baby instantly more comfortable.

 

So, if you are dealing with a baby who is having a hard time sleeping unless he is held, who screams during or after feedings, acts hungry but then after a few sucks pulls away, is congested a lot, seems to have unexplained coughs or hiccups, often arches his or her back and neck and seems to scream a lot, it is worth digging deeper into the cause as these little ones can be helped if diagnosed correctly.

 

Tonya is a Newborn Care Specialist who does both consulting and in-home sleep training.  She has more than 20 years experience and is a mom herself.  In addition to being credentialed through the International Nanny Association where she serves as the Chair of INA’s Nanny to Nanny Mentoring Program and is frequently asked to speak at INA’s annual conferences.  Tonya was awarded the Professional Childcare Provider of the Year in 2003 and nominated for INA’s Nanny of the Year in 2004 and for the National Association of Nannies Harriette Grant Memorial Award.  She can be reached via http://www.babydreamteam.com.

Panic or Patience? When to take a child to the Emergency Room

Q & A with Emergency Physician Dr. Wayne Warrington

 1. When my child has a fever, at what point do I need to seek emergency care?
Fevers are a medical emergency when: they cause seizures, are unrelenting for several days, don’t resolve with appropriate doses of ibuprofen and/or acetaminophen or if the child appears lethargic, in any acute distress or associated with bizarre behavior.

2. Should I take my child to the ER in the middle of the night for an ear infection?
An ear infection, in and of itself, is not usually a medical emergency. But sometimes the associated symptoms, such as severe pain or persistent fever, can be. Getting your child an emergent dose of antibiotics is not necessary. In fact, in
Europe, most clinicians do not routinely treat kids who have inner ear infections with antibiotics. It has been postulated that our overzealous use of antibiotics has caused resistant strains of many bacteria.

3. When should I call the doctor rather than go to the ER?
If your child is not in extremis or having a severe [attack], you can probably take 5 minutes to try and get your pediatrician’s advice. He/she may save you hours of waiting in a crowded Emergency Department!! Of course, if you are concerned that your child needs to be seen right away, then my standard response is don’t hesitate to come the ER.

4. For wounds, how do I know if my child needs stitches?
If you are able to pull the edges of the wound apart or the underlying tissue is exposed, it probably needs a stitch. If the bleeding is profuse and will not stop bleeding after direct pressure, it probably needs a stitch. And remember, there is a time limit on how much time after the injury the wound can be sutured. In addition, every hour a wound is left open equals more exposure to bacteria that can form its own little colony when the wound is finally closed and there is a good anaerobic environment.

5. When is a burn an emergency?
When it causes severe pain, or when the area is charred or white and there is NO pain (3rd degree). Usually, 1st degree burns (without blisters) that resemble a sunburn do not need to be seen immediately. 2nd degree burns are usually severely painful and should be seen by a doctor for analgesia, cool towel wraps, burn cream application and prescription.

6. If my child has never had an allergic reaction before, can he have a severe reaction the first time?
Absolutely! Anyone can be allergic to almost anything at any time, and the first time can be anaphylactic shock!!  Many people wonder why they suddenly become allergic to a food when it was the one-thousandth time they ate or
were exposed to it. It happens!

7. If my child is healthy and has what looks like a seizure, what should I do? What does a seizure look like?
If it is a first time seizure, you should definitely seek medical attention. If he or she has had seizures in the past, then you will know what to look for (past symptoms). There are a few types of seizures, but most of them involve a loss of consciousness, trembling all over and maybe frothing at the mouth, eyes rolled back in the head, bowel or bladder incontinence (not always) and shaking all over. A patient who can talk to you during their seizure or respond to your comments during the event is probably not having a real seizure.

8. How do I know if my child has a broken bone and whether I should call the doctor for treatment or go to the ER?
If you call your doctor with a story like that, 99% of them will tell you to come see me (in the ER) since very few family physicians have X-ray capability and it will be impossible for your doc to tell you definitively if your child has a fracture. If you suspect your child has a fracture, by all means come see us!!

9. At what point should a child with asthma be taken to the ER?
Go to the ER if breathing becomes increasingly difficult despite the use of your child’s home nebulizer system. When a child appears to be struggling to keep awake to breathe, of course you should bring him or her in. I might even call 911 in that case. If you feel the medication isn’t working and your child is working harder to breathe, by all means come see us.

10. If my doctor tells me my child is fine, but I still feel my child is sick, should I go to the ER?
Absolutely!! I am a strong believer that most moms have certain instincts that know when their child is in trouble. When in doubt, call 911.

11. If my child has the stomach flu and is vomiting all day and I have spoken to the doctor, but they say to stay at home, give fluids and rest, at what point does it become an emergency situation?
When the child is unable to keep down fluids, the child looks dehydrated (i.e., sunken eyes, dry lips, decreased or lack of urine output) or is lethargic, seek emergency help.

12. Are there times when it is better to call 911, rather than walking into the ER?
Again, if your child is in extremis, unresponsive, lethargic, or bleeding profusely… call 911.

Bio: Specialized in Emergency Medicine Wayne Warrington, DO graduated from Kansas City University of Medicine and Biosciences-College of Osteopathic Med. in 2002. He now lives and works in Hawaii.

This article was courtesy of Britt Michaelian, author of Safety Goddess Book, founder and CEO of Responsible Family Company, http://ResponsibleFamily.com