Sunday, November 22, 2009

Teens, Children, and Infants Oh My!

Okay really I'm not going to talk too much about teens and children. I'm mostly going to talk about infants.

I took a class (one of many) from the hospital about giving birth and visited a pediatrician. And I've also worked at a day care so I know infant regulations from my state like the back of my hand. Seriously, my boss would actually relied on me a lot because I would remind other workers about silly things (well silly rules in my opinion) such as not turning off the lights if the children were having a movie day. I know it's a safety issue so that the children can see to exit but movie theatres also have to deal with things like fire and tripping over empty popcorn buckets and they still can turn the lights off. But I digress.

So a number of things came up, but one important thing is vaccinations. Not everyone is comfortable with vaccinations. I had to get two flu shots this year and I had to make sure that they didn't contain the preservative (mercury) or the live virus. So for those who are concerned about those things being in your flu shot, please be aware that you can ask the health care provider to give you the type without the live virus or mercury.

All parents face the decision to vaccinate their children or not. Some don't for religious reasons. At the day care I worked at there was one family where the children were not vaccinated. In order to have your children attend you have to have the vaccinations registry or a note from your doctor opting out. And every year the day care has to do an internal audit to make sure that every child has their vaccines up to date for their age. This family opted out for "religious reasons" which probably doesn't mean anything. You only can only have health or religious reasons as plausible reasons for opting out. Ironically the mom worked in the medical field so you would think that she knew the pit falls of not having her children vaccinated. My biggest concern was for the health and safety of her young children. I warned my co-workers to watch out for things like rusty nails and other dangers. We do anyway, but if this child is exposed to say chicken pox, polio, measles, or tetanus and rabies, it would pose a huge health risk. Other children would be vaccinated so their reactions would not be as great. Plus we're talking about a day care. Children can't often describe their symptoms and so things that seem like colds can turn into the flu or mono. I thought that I had a really bad case of the flu until I discovered it was mono and I still to this day don't know how I got the "kissing disease." Other things like measles and chicken pox have long gestational periods where you don't know that you have the virus until you've already exposed several people to it.

So what does this have to do with anything. Well here's the thing. Parents are really bad about not keeping their children's vaccines up to date. I mentioned the internal audit. One of our four/five year olds was so far behind on her vaccines that in order to remain at the day care we had to send her to get SIX shots all at once. Her arm was sore and we had to keep an eye out that she didn't have a reactions. We had to give her over the counter Tylenol to relieve the pain. As the nurse at the peds office said, you really want to give the same shots to the parents so that they will understand how stupid that was. Plus some people don't stick too well to the schedule. The nurse said one of the children they treated who came from over seas didn't have any vaccines (which is really common in poor countries). They discovered at the office that the child had contracted polio. Because one of the other patients did not have their up to date vaccine for polio, the patient was exposed and also contracted the disease. I know someone who contracted polio before the vaccine was discovered. He has leg braces and trouble walking. It's not something you want your child to contract. So please stay up to date. Vaccines are not as expensive as the medical care you would need if your child contracted polio.

Tooth decay is also a big problem with infants and children. When my cousin was a child he went to the dentist and was told that he had a cavity. My uncle was told to schedule an appointment but he didn't and later forgot to. One day my cousin was complaining to my grandmother about his tooth. She asked him why and he told her about the cavity. She immediately took him to the dentist who had to give him a root canal. All of this could have been avoided if my uncle had gone ahead and made an appointment. Even if you're not sure what your schedule will be. You can at least change it later. Dentists and doctors are good about reminding you of appointments that you've made, but I've never heard of them reminding you to make appointments that you need.

Infants are especially prone to things like bottle rot. This is where parents get in the habit of sending their child to bed with a bottle. The bottle stays in the mouth and breeds bacteria. Children should never go to bed with a bottle. And you should always wipe their gums with a cloth or brush their teeth after eating. Day cares aren't allowed to send children to bed for this very reason. I can firmly attest to how hard it is to put a child who is used to having a bottle in bed to bed. And some parents (after explaining that not only is it state law but bad for their teeth) will still insist on the bottle. Even for children who are one year or older. For the record no child age one or older should be given a bottle or a pacifier. They should progress to a cup. The day care had to lie to parents about bottles and tell them that because we don't accept infants we cannot accept bottles. This is not true; the state doesn't have a regulation for this. But if we don't tell parents this, we would end up having children who are three years old still insisting upon drinking from a bottle. Some parents have no back bone and let the children dictate at the child's perilous health.

Anyway the thing that concerned one potential parent at the class was SIDS. I actually knew a grandfather who lost his grandchild to SIDS so it does happen although not as frequently. Especially if you follow these rules. Don't smoke. Even if you choose to smoke outside your house (which is better than smoking inside) the child can still inhale the smoke residue from your clothes when you hold them. Smoking has been linked to SIDS. Allow the air to circulate. Fans seem to help reduce the incidence of SIDS. Some people believe that the child inhales too much CO2. If you keep the air flowing in the room that they are in, it seems to help. Pacifiers reduce the instances of SIDS. I'm not a big fan of pacifiers and for breast fed babies, pacifiers are not recommended to be used until 3 months of age when breast feeding patterns are well established. I'm a fan of thumbs. Most infants can use their thumb without too much need to guide them. Also never place infants on their stomach or side for sleeping. Always place them on their back.

Also the big one is cribs. Make sure that your crib has not been recalled. Make sure that the rails are spaced no more than 2 3/8 inches (6 centimeters) apart. Grandma may insist on using a very old family crib. Be nice and measure and be prepared to say no. Inside the crib there should be: swaddled baby, mattress, fitted mattress protector, and fitted sheet. That's it. No pillows, no loose sheets, no loose blankets, no bumpers, no stuffed toys, nothing else. These all pose chocking hazards. Now let me explain a few things to the surprised. Pillows can be used if approved by your pediatrician. In day cares we can only have what I described above (baby, etc). However if a child suffers from acid reflux, a parent can sign an IEP (Individualized Education Plan) and bring in a note from the doctor explaining the use of a pillow. Otherwise day cares will tell you that Mr. Snuggles can't be used in the crib. Bumpers were for older cribs who had rails spaced too far apart. They were designed to keep baby from getting its head stuck. Modern cribs don't have that problem so bumpers are cometic and dangerous. The ties can get caught around a baby's limbs or neck and the baby can roll over into a bumper but perhaps not back and smother itself. But many stores still sell bumpers in the cute crib sets. Don't get suckered in. Not only are bumper hazardous but all you need is sheets and a few swaddle blankets. These are not expensive compared to getting the fancy crib blanket and dust ruffle etc which you don't need anyway. Toys and blankets are also no nos like the bumpers because babies can get rolled up in or on them and smother themselves.

Now my lovely grandmother-in-law made this beautiful quilt for my son. She beamed at the baby shower and said "it's crib sized." Boy, did I bite my tongue. My son will never sleep with that quilt in his crib. He may use it for "tummy time" and he may use it when he's a toddler and when we convert his crib. But he won't use it while he's an infant. I suppose if she asks I'll have to be honest about why we don't use it much. I hope that her feelings won't be hurt. It is very beautiful but after he's born it's just another hazard.

Speaking of tummy time, it's important for the baby to have tummy time after the embilical cord has fallen off and healed. Otherwise baby's develop a flat spot on their head and the hair in that area is worn off. It also encourages them to work on their neck muscles. Here are some more no nos. Do not leave your child lying on their back for long periods of time. I mentioned why it's important for tummy time, but you can also sit the child up or cradle the child while they are awake. Sitting them up is good for relieving gas. Do not leave your child on their stomach on a fluffy surface like a bed. If your bed is firm and the blankets aren't too thick, then you can probably get away with it. But it's best to spread out a blanket on the floor and lay them on it. Do not leave your child unattended during tummy time. If your sleepy, put them back in the crib. Otherwise you could fall asleep and your child could smother itself.

Never leave your child on a high surface. My dad left me on the counter top and I rolled off and fell on the floor. I don't think it left permanent damage (you be the judge), but it sure scared the devil out of my dad. So don't leave your child on the bed, diaper changing table, or couch. Transfer them to a play yard, crib, or the floor on their back if you have something to attend to. And never handle anything hot around an infant. If your drinking coffee while nursing, you could accidently spill some and burn your baby. Also don't leave your child around your pets unattended. It's an old wives tale that cats and children don't mix. But you still have to be careful that your baby doesn't aggrivate your pet by pulling it's tail. Otherwise the pet can scratch or bite out of defense. At night shut the door to keep pets away from baby. There are ways to introduce pets to baby, but that's another blog. Never leave a child near water for any reason. That includes baths. Wrap them up and take them with you. Don't use the old mercury thermometers; they break. I've broken one as a child and scared my mom. So I hope that if she's reading this she will remember to throw hers out. Inspect toys for small parts or broken parts. Talk to your peditrician before introducing foods and administering medications.

And I think I've covered up to when infants begin to toddle. That will be another blog. Titled child proofing. But the important message is to educate yourself and those who will be caring for your infant. Things change all the time. I even learned that they've changed the cpr measures so even if you were a life guard in highschool and think you know cpr. Make sure you take a class and update yourself. It's better to know too much than too little when it comes to safety.

1 comment:

  1. You just made me smile...

    I will say that most non vaxing parents do a ton and a half of research... and it doesn't bother me that they don't get them as long as they do that & have their reasons. I've heard some good ones (a friends kids had bad reactions, dr's said no to anymore). We do vax btw... most of them anyway... I would like to delay them and there are a couple that we refuse, but for the most part I think they're pretty important. Question about the rabies thing... Kids get vaxed for that? I have never heard of that one...

    I got a lot of those blankets too.. and similar comments. Yeah they are great for tummy time and sit in a drawer the rest.

    The smoking thing... is even more important if you co-sleep. Think about all that smoke hanging off the parent right next to them all night. My cousin did that & after I started researching it all my jaw about dropped... We dont smoke so non issue here, we just had to make sure there were no blankets close by (or pillows) and she couldn't believe we went that far. Not risking SIDS though... I'm a bit paranoid about that. Looking into either wrapping the mattress (I forget what its called but a study in Australia showed it helps) or using an organic mattress next time for when the baby transitions... Cut risks further.

    I'm not a fan of pacifiers either... Was ticked the hospital we used last time gave one to Kalila.

    We need to get her into the dentist soon. I dont think there's any issues yet, but still... it needs to be done. Btw, the bottle thing isn't just bad on teeth (laying down with it), but causes ear infections. Sure you know that, but still a big point. Non issue here but something I keep in the back of my head because I run across so many people that don't know that one.

    Sorry I'm rambling again. This is another fav topic of mine :-D


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