Palak Vyas

In younger infants, there can be multiple reasons for reflux:<ul><li>Overfeeding</li><li>Weak abdomen muscles</li><li>Immature esophageal sphincter muscles</li><li>Slow digestive system</li><li>GERD - a digestive disease where the fluids and foods from the stomach come back up to the oesophagus</li></ul> Sleep solutions:<ul><li>Do not put your infant to bed immediately after feeding.</li><li>Make them burp.</li><li>Wait for 30 minutes before lying down your baby on bed for a nap or night sleep.</li><li>While you wait for 30 minutes, be sure to hold him/her upright.</li><li>Keep rocking your baby in standing position till (s)he sleeps naturally.</li><li>To avoid acid reflux, give your baby small but frequent feedings.</li><li>In case you are feeding with a bottle, take a closer look at the nipple size. It should not be too small or too big. If the hole is too small, the child keeps sucking hard and instead of milk (s)he sucks in air. If the hole is too big, (s)he won’t be able to take that much amount at a stroke.</li></ul>

Many children have a problem of reflux (spitting/vomiting out the food) when they go to sleep. Certain sleep positions will help with this problem.

Sleep solutions for babies with reflux or GERD

Sudden Infant Death Syndrome (SIDS) is also known as cot/crib death. As per the name, it is a sudden unexplained death of a child under 1 year of age with no explainable reasons after a thorough biopsy. SIDS is more likely to occur between 2 to 4 months of infants. SIDS is more prevalent in boys. Most SIDS deaths occur in the winter. Causes: The cause of SIDS is unknown. Researchers believe that low levels of oxygen or a build-up of carbon dioxide in the blood might be the reason behind SIDS. When babies sleep face down, they may re-breathe exhaled carbon dioxide and so the CO2 levels rise in the blood. Risk factors of SIDS:<ul><li>Sleeping on the stomach.</li><li>Being around cigarette smoke while in the womb or after being born.</li><li>Soft bedding in the crib.</li><li>Multiple birth babies (being a twin, triplet, etc.).</li><li>Premature birth.</li><li>Having a brother or sister who had SIDS.</li><li>Mothers who smoke or use illegal drugs.</li><li>Being born to a teen mother.</li><li>Short time period between pregnancies.</li><li>Late or no prenatal care.</li></ul> Diagnosis: A baby is determined to have died from SIDS if no cause of death can be identified. Treatment: There is no treatment available for SIDS as of yet. Preventive measures:<ul><li>Put your baby to sleep on his back.</li><li>See that you don’t put extra pillows, blankets or bumper pads in the bed with the baby.</li><li>See the baby doesn’t get too hot.</li><li>Always use a firm sleep surface for baby’s the bed.</li><li>Keep your baby away from smoke and smokers.</li><li>Use of pacifiers reduces risk of SIDS, although the reason is unclear.</li></ul>

Here are SIDS Causes, Risk factors, Diagnosis, Treatment, and Prevention.

All about Sudden infant death syndrome (SIDS)

Samiksha Choithani

A child gets nutrients and oxygen through the umbilical cord when the baby is in the womb but after birth the umbilical cord is not needed and hence it is tied (clamped and snipped) leaving behind a short tail like rod. This too will dry and fall off. Until then take a little extra care:&nbsp;1.)&nbsp;&nbsp;Keep the cord dry, you can use the powder that your paediatrician has suggested2.)&nbsp;&nbsp;If you are not comfortable in keeping it dry while bathing, you can go for sponging for first few weeks3.)&nbsp;&nbsp;Do not try to pull it off, let it dry and fall off.&nbsp;Sometimes it may bleed when the cord falls off that are normal do not worry about it.

A child gets nutrients and oxygen through the umbilical cord when the baby is in the womb but after birth the umbilical cord is not needed. Read more to know how you can take a little extra care.

How to take care of my child’s umbilical cord?

If your baby cries for excessively for too long and cries frequently despite your best attempts to soothe or console, your child might be having Infantile colic (I.C). Infantile colic starts at about 3 weeks of age and self-resolve by 6 months. Do not feel guilty about not being able to soothe your child because more children than you would assume have infantile colic. Colic and crying are different. All babies cry but not all are colicky. When babies cry it is to grab your attention to matters like hunger, wet diapers, tummy troubles, teething, or an underlying illness. And this is not colic. Ideally a colicky infant cries for more than 3 hours a day, for more than 3 days a week, and for over 3 weeks. Babies with colic are healthy, gain weight normally, and do not have digestive complaints or other known ailments. Other symptoms of colic are flushed red face when the babies cry, fussiness with arching back, drawing knees to the stomach, or clenching fists. The exact reasons for colic are still a mystery. The digestive system of infants is immature and this can lead to colic. Your child’s doctor will diagnose colic based on the symptoms, intensity and duration of the crying episodes. Managing my colicky baby:<ul><li>Ensure that your baby is not hungry or cold. Make sure to change the diapers regularly.</li><li>Always hold your baby upright while feeding and burp your baby after feeding. This prevents swallowing of air.</li><li>Bathe your baby in warm water, while gently massaging your baby's stomach.</li><li>Identify the time your baby gets fussy determine if anything seems to trigger or relieve the crying baby. Talk about your diet with your doctor, the doctor may suggest to skip some gas-producing foods from your diet.</li><li>Try new positions with your baby, swaddle them tight or massage may help. Try to turn your baby on your lap, make them sleep on stomach, and gently massage on back.</li><li>You can also try some sounds, a car ride or take them out in a pram. Sometimes changing the surroundings and outdoors may do the magic.</li><li>Take turns with family members to handle a the baby when they fussy.</li><li>When the baby is crying cradle or rock your baby in your arms. The comfort of your arms might calm your baby!</li><li>Sometimes, your child’s doctor might prescribe colic drops for your baby’s relief. But mind well that colic drops should only be given to a child after a doctor’s prescription.</li></ul> Seek immediate medical help if your baby develops other complications like breathing problems, turns pale, refuses to feed and vomits green fluid, or has traces of blood while passing motion.

Crying and colic are not the same thing and so it is important to identify the difference and address it.

Crying & Colic Symptoms & Solutions

Ravina Sewani

In Vitro Fertilisation, commonly known as IVF, is a process that helps to overcome female infertility. In some cases, it can also help with male infertility. In IVF, the egg and sperm are fertilised outside the mother's body in a test tube. Hence the babies born through IVF are sometimes called as test tube babies. The fertilised embryo is them implanted in the mother's womb or another woman's womb. Steps of IVF:<ul><li>Egg production stimulated by hormone therapy</li><li>Egg retrieval from ovary</li><li>Sperm Sample Production - happens on the same day of egg retrieval</li><li>Fertilisation of egg and sperm in a test tube</li><li>Transferring fertilised eggs into the uterus</li></ul> The woman who wants to opt for IVF, is given fertility medications for 10 to 15 days. These medicines stimulate the ovaries to produce more eggs. For these 10-15 days, the woman is required to visit the doctor regularly for blood tests and ultrasounds. Once the stimulation period is over and sufficient eggs have been produced, the eggs are removed from the woman's body and are infused with the woman's partner's sperms in the laboratory. After three to five days, when the embryo reaches the 180 cells stage, one or more embryos are transferred back into the woman's uterus from the test tube. About two weeks later, you will be required visit your doctor to determine if the IVF was successful or not. Once the embryo is transferred to the womb, it develops inside the mother. The rest of the pregnancy happens in a normal way. Sometimes if the woman's womb is incapable of nursing the embryo, another woman's womb is implanted with the fertilised embryo. This is called surrogacy. Keep in mind that IVF cycle is time consuming and expensive. Things to keep in mind for a successful IVF:<ul><li>Maintain a healthy weight</li><li>Quit smoking</li><li>Limit your alcohol intake</li><li>Keep your blood pressure and diabetes in check</li></ul> Side effects of IVF:<ul><li>Emotional ups and downs during the IVF cycle</li><li>Cramping in the pelvic area</li><li>Breast tenderness.</li><li>Ovarian hyperstimulation syndrome (OHSS). This is very rare and it occurs when fertility drugs cause a woman to make too many eggs. The symptoms of OHSS are weight gain, swelling in the abdomen, dizziness, nausea, and vomiting.</li><li>A minute risk of multiple pregnancies or birth complications. Doctors generally implant more than one embryo during IVF to increase the chance of getting pregnant with multiple babies. This increases the risk of premature labour and underweight babies. To avoid these complications, some people and doctors opt for one embryo implantation.</li></ul> Who can opt for IVF?<ul><li>Unexplained infertility</li><li>Blocked fallopian tubes</li><li>Male factor infertility</li><li>Older patients who desire to have a child</li><li>Low ovarian reserve</li><li>Polycystic Ovary Syndrome (PCOS)</li><li>Endometriosis</li><li>Premature Ovarian Failure</li></ul>

Couples facing infertility problems can opt for IVF.

Opting for In Vitro Fertilisation (IVF) or test tube baby

Circumcision is a small surgery where the skin covering the tip of the penis is removed surgically. The decision to get your baby circumcised depends on cultural, religious, medical or personal reasons. Let the paediatrician or neonatologist decide if the child is ready for circumcision or not.<ul><li>Your baby’s penis may be sore for a few days after the procedure.</li><li>You have to be careful while bathing and changing diapers until it heals completely. Do not use any bathing products. You can use warm water to clean the area.</li><li>Whenever you change the diaper, use a new dressing as per your child’s paediatrician’s advice.</li><li>Use a dab of petroleum jelly on the penis so that there is no friction with the diaper.</li><li>Healing after the surgery can take up to 7-10 days.</li></ul> Inform your child’s paediatrician if you see any of the following signs:<ul><li>Bleeding that continues</li><li>Fever</li><li>Infection</li><li>Redness that gets only worse</li><li>Pus filled blisters</li><li>If the child does not urinate within 12 hours after the circumcision.</li></ul>

Circumcision is not necessary but the decision depends on personal beliefs.

Undergoing circumcision in boys

Babies who are prematurely born may have complications as some of their organs haven’t yet fully developed. Premature babies can have complications in the first few days, weeks or months and so are first kept in neonatal intensive care unit (NICU) for survival and to provide optimal environment for growth. Kangaroo care (skin-to-skin contact) is a unique practice where a baby is taken care of outside the incubator. The baby is positioned directly on the mother's bare chest after birth and is covered with a warm blanket. Care should be taken to not move the baby too far away from the incubator as the machine is connected with tubes and wires. There are several benefits of Kangaroo care. They are:<ul><li>Kangaroo care regulates baby's body temperature and heart rate.</li><li>It promotes baby's digestion and improves oxygen levels for the baby.</li><li>It helps babies sleep longer, thereby promoting growth and protection from infections.</li><li>Kangaroo care releases hormones that support breastfeeding and increases the volume of volume that contains antibodies.</li><li>It is a great practice to develop the bond between the mother and the baby.</li></ul>

Kangaroo care is a method of holding a baby that involves skin-to-skin contact with the mother.

Kangaroo care for children

Choking occurs when your baby takes more milk into its mouth than (s)he can swallow at a time. Excess milk spills into the airway and blocks the flow of air, which leads to choking. It can be a frightening sight for any mother to see her baby coughing and sputtering milk while struggling to breathe. Reasons behind choking during breastfeeding:<ol><li>Milk oversupply- When a mother produces excessive milk, the milk releases from the milk ducts in a forceful and almost explosive manner. This is called Milk Ejection Reflex. The baby is not able to swallow that much amount easily and starts choking up.</li><li>Improper latch</li></ol> You might be producing excessive milk if you notice:<ul><li>The baby is choking, gagging.</li><li>The baby is trying to clamp the nipple to slow down the flow.</li><li>The baby is trying to pull away from the breast.</li><li>The baby is refusing to nurse and is spitting up frequently.</li></ul> What to do:<ul><li>When you find your baby choking on milk, there are methods that can dislodge the milk from blocking the airway. Since babies have delicate bodies, it must be done with caution.</li><li>Turn your baby upside down and give them intermittent back blows and chest thrusts combined with gentle taps to the back, to open up the airways. The chest thrusts should be given with two or three fingers on the lower half of the breastbone, while supporting the head with the other hand. This should be continued until the block is removed.</li><li>It’s important to note that if the baby doesn’t recover and becomes unconscious, (s)he should be rushed to the nearest hospital, while still continuing the dislodging procedure.</li></ul> Prevention:<ul><li>Try and slow down your supply: Say if you are nursing with the right breast, then press your left nipple of the left breast with your right hand’s palm toward ribs and count till five. This signals your body to slow down the flow.</li><li>Stick to a single breast for a few feeds: This way one of the breasts gets fully emptied and this also slows down the flow in the other breast.</li><li>Baby’s latch: Ensure that the baby is latched properly. If the baby is latched properly, the milk should directly get into the baby’s throat and not his mouth. So when the latch is not proper, there is more risk of the baby’s mouth getting filled up with milk more than it can take and that is when your baby might end up choking.</li><li>You can recline on a surface and then feed the baby in your arms. This is a good nursing position.</li><li>While breastfeeding, if the other breast feels uncomfortable, you can express some milk from it and apply a cool compress to relieve the discomfort. As you continue this procedure, express lesser milk, until there is no need to do so.</li></ul>

A breastfeeding child chokes when (s)he takes more milk in mouth than (s)he can gulp down.

Choking during breastfeeding

Premature babies need extra care, attention and warmth. Here are some things to do in the early days to help your baby thrive:<ul><li>Limit visits: Visits outside the home should be limited to the doctor's office for the first several weeks, especially if your baby is discharged during the winter months. Because doctors' offices commonly have several kids with viral infections, try scheduling your appointment as the first of the day or request to wait in an examining room instead of the main waiting area. Ask the doctor how limited your baby's contact with other kids and adults should be during these first weeks.</li><li>Avoid public places and some visitors: Most doctors recommend not visiting public places with premature babies. Limit visitors to your home: anyone who is ill should not visit, nobody should smoke in your home, and all visitors should wash their hands before touching the baby. Talk to your doctor about specific recommendations.</li><li>Put your baby to sleep on the back: Babies' success at feeding and sleeping is important to their health. Expect your premature baby to sleep more than a full-term baby. All babies, including preemies, should be put to sleep on their backs to reduce the risk of sudden infant death syndrome (SIDS).</li><li>Practice kangaroo care: Take advantage of these quiet weeks together to enjoy skin-to-skin contact, also known as kangaroo care. In a warm room at home, dress your infant in only a diaper, then place the baby on your chest and turn your baby's head to one side so that his or her ear is against your heart. Research shows that kangaroo care can enhance parent-child bonding, promote breastfeeding, and improve a premature baby’s health.</li></ul>

Premature babies require more care in their upbringing at least for the first few years.

newborn health concerns

Following article(s) will help solve your concern.