What New Parents Want to Know: 10 Commonly Asked Questions

Brought to you by Wolfson Children’s Hospital

Whether you’re a first-time parent or you’ve been through the experience before, wondering if you’re doing the right thing is a natural reaction to the challenge of raising a child. Even if it’s something you’ve dealt with on the first go-around, every child is unique, so experiences may vary. From worrying if your baby is eating enough to how much medicine you should give your three-year-old, there can be lots of self-doubt when it comes making sure you’re doing what’s best for your son or daughter.

Pediatricians, emergency medicine physicians, physical therapists and other pediatric caregivers have heard all of the questions, and a few of ours have come together to share a few of the ones they are most often asked.

Woman breastfeeding baby

Q: How can I tell if my newborn is getting enough breast milk?

A: Monitoring the number of wet diapers and bowel movements is the easiest way for parents to confirm that their baby is getting enough breast milk. Once a mother’s milk is established in the first few days, most babies should produce about six or more wet diapers and three or more stools daily. Consistent weight gain is the best way to assure a baby is feeding adequately, but unfortunately, this is impractical on a day-to-day basis. It can also be deceiving at first because most babies lose weight initially, taking a week or two just to get back to their birth weight.

Randolph Thornton, MD, a community pediatrician and Chair, Pediatric Medicine, Wolfson Children’s Hospital

 

Q: How can I reduce the risk of Sudden Infant Death Syndrome (SIDS) for my baby?

A: In the U.S., SIDS is a leading cause of death in babies between one and four months old. While it can occur out of the crib, it most often happens during sleep between 10 pm and 10 am. The cause is not fully understood. The key recommendations to decrease the risk include:

  • Always putting babies to sleep in their backs. Once they roll over at about four months old, the risk of SIDS markedly decreases.
  • Choosing safe bedding and avoid blankets, pillows and soft toys that can suffocate an infant.
  • Always having babies sleep in their own beds. Placing the crib in the bedroom with you is fine but never co-sleep.
  • Allowing pacifier use.
  • Avoiding overheating a baby. Keep the environment comfortable for the parents, and use no more than one extra layer for the child.
  • No smoking.
  • Breastfeeding, if you can. Breast milk cuts the risk of SIDS in half.
  • Making sure your baby gets all of the recommended vaccines.

(For more information about sleep safety, visit Ready, Set, Sleep!)

 Thornton

Wolfson-Shot

Q: Are vaccines safe and is it OK to space them out?

A: Yes, vaccines are safe. They’ve been studied for their safety as well as their ability to prevent diseases that have the potential of making children very ill – possibly causing death in some cases. Spacing them out, however, is dangerous. Parents worry that they might be overloading their babies’ immune systems but that’s not true. It’s important to go by the standard vaccine schedule approved by the American Academy of Pediatrics (AAP). They’ve looked at which vaccines are appropriate to give and at what ages because those are the ages when infection is most likely to occur. Any delay puts the child at increased risk.

Mobeen Rathore, MD, Chief, Division of Pediatric Infectious Diseases and Immunology at Wolfson Children’s Hospital

 

Q: For a teething infant or to treat a fever, what are the rules about alternating acetaminophen and ibuprofen, and how long can you do it safely?

A: I don’t recommend alternating acetaminophen (Tylenol) and ibuprofen (Motrin), and there is no guideline from the American Academy of Pediatrics (AAP) for this either. Research has shown that when parents do this, they under-dose the medication, which makes it less effective. I recommend treating with one medication or the other using the dosing guidelines that can be found at the AAP’s site healthychildren.org. There certainly are benefits to treating fever in children, but there can also be pitfalls. Fever plays a role in fighting infection, but also can make your child uncomfortable. When determining if you should treat your child with medication, remember that the height of the fever is not always as important as how your child is acting. There are certain guidelines that apply to specific situations when dealing with fever, but every child is unique. Therefore, it’s important to consult with your child’s primary care physician when your child has a fever.

Anthony Pohlgeers, MD, FAAP, Medical Director, Pediatric Emergency Medicine, Wolfson Children’s Emergency Centers

 

Q: My teenager wants to become a vegetarian but I’m worried she won’t get the nutrients she needs. What are her options?  

A: Following a vegetarian diet can be healthy if the following nutrients are included:

  • Protein, which helps to fuel the muscles, and vegetarian sources include beans, nuts, lentils, tofu and nut butters.
  • Iron is important in red blood cell formation, and sources include leafy greens, raisins, prunes and iron-fortified grains.
  • Calcium’s role is for strong teeth and bones, and you can find it in leafy greens, tofu and fortified milk and juices.
  • Vitamin D helps the body absorb calcium. The best source is natural sunlight, but other sources include fortified milk, cereal and orange juice.
  • Vitamin B12 helps the metabolism and is important in the formation of red blood cells. You can find it in fortified cereals, meat alternatives and multivitamins.

Jodi Ervin, RD, registered dietician, Wolfson Children’s Hospital

 

Q: Is it important for my child to crawl?  

A: Yes! Crawling is important for infant development, and contributes significantly to strength, balance, visual-spatial skills, spinal alignment and social development. Here are some reasons why:

  • Putting weight through the hands and wrists helps to develop the arches in the palm, which helps with fine motor skills and grasping.
  • Pushing up on the arms to lift the body off the floor strengthens the shoulders, arms and legs.
  • The movement of crawling impacts development of baby’s spine.
  • While crawling, a baby will look ahead for direction, and then look back down at his or her hands, developing the ability to focus the eyes on objects near and far. This contributes to binocular vision (using the eyes together as a team), an important skill for reading and handwriting in the future.
  • It encourages the right and left sides of the brain to work together, a foundational skill for more advanced motor coordination.
  • Socially, crawling allows a child to explore and learn about boundaries, to engage with others in a voluntary manner, to set goals, and to succeed or fail at meeting those goals.

Karen Reckamp, OTR/L, Manager, Wolfson Children’s Rehabilitation
Anne H. Zachry, OTR/L, PhD

 

Q: When should I start my baby on solids?  

A: The American Pediatric Association recommends starting baby foods at six months old. Baby foods and purees give an infant the opportunity to learn beginning feeding utensil skills, as well as experience tastes and textures. Babies have the motor skills to manage soft table foods and easily melted hard foods by 9 months, by when they can self-feed, including biting off pieces from a soft cookie.

Kerry Glidewell, MA, CCC-SLP, pediatric speech/language pathologist, Wolfson Children’s Rehabilitation

 

Q: When should I wean my baby from a bottle?  

A: Infants can be introduced to cups as early as 4 to 6 months, and usually respond better to cups with flow control such as a sippy cup. Some are able to manage a straw as early as 8 to 9 months. It’s generally recommended that bottles are weaned by baby’s first birthday.

Glidewell

 

Q: When is it safe for my child to transition from a 5-point safety harness to a seat belt in his or her booster seat?  

A: The best practice is to keep your child in a harnessed seat as long as possible before moving him or her into a belt-positioning booster seat. Weight limits on those can be from 40 to 65 pounds, so parents should shop carefully and purchase a seat with higher limits to provide the safest ride longer. According to the law, children must be in a seat with an internal harness at least until age 4, and in either a booster seat or 4-point harness until age 6.

 Jessica Winberry, BSH, certified child passenger safety technician, Safe Kids Northeast Florida

 

Q: How do I know if my child has a health issue that’s serious enough to go to the ER?  

A: Always trust your gut. If you think it’s an emergency, don’t hesitate because you know your child best. If you’re still hesitant to dial 911, a quick call to the pediatrician or primary care physician for advice, even after hours, can’t hurt. Indicators of a medical emergency include:

  • A wound that won’t stop bleeding.
  • Breathing problems like shortness of breath or difficulty inhaling/exhaling.
  • A blow to the head that causes loss of consciousness, disorientation or sleepiness.
  • Suspicion of poisoning.
  • A faster-than-normal heartbeat that doesn’t slow with rest.
  • Stiff neck with a fever and disorientation.

Candice Ramesar, BSN, RN, Director of Wolfson Children’s Emergency Centers

 

The information above is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding your child’s medical condition.

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