Thursday, February 7, 2013

13 Good Things to Know About Baby (that you may not have heard)

So there is a ton of information out there, and sometimes it can make your head spin, but the following information are things that I feel are important for all moms to know, and they aren't the things we've all heard over and over again (like put your baby to sleep on their back to prevent SIDS).  I hope you find it helpful.

1.  Rectal temperature is the only accurate temperature during the first year of life
Ear thermometers over estimate temperature and all other methods (under the armpit, pacifier thermometer, temporal thermometer, etc.) under estimate temperature.  For the first year of life, the degree of a fever is very important and will determine whether your child needs to see a doctor or not, therefore it is important to have an accurate temperature.  I recommend the Vick's Pediatric Rectal Thermometer as the easiest way to get your baby's temperature rectally.  It's got a short shaft to make sure you get it in far enough, but not too far, and it only takes 10 seconds.  Just place baby on the changing table, open up their diaper, lift their ankles up like you would when you are wiping their bottom, insert the thermometer and 10 seconds later you're done.  Your baby won't even notice anything happened.

2.  Your baby's body temperature may not set at "normal" until 6 months of age
My baby was a hot body from day one.  He always felt like a little lump of burning coal, and he was sweating all the time.  That guidance of "dress your baby in whatever you are wearing, plus one layer" didn't apply for us.  It was quite the opposite.  We had him in minus one layer.  If you took his temperature, it was always hovering around 99.2 or so, but never over 100, so he wasn't running a fever, he was just hot.  I asked my pediatrician about this, and he said that as babies' bodies start to learn to regulate their own temperature, sometimes they "set" a little high or a little low at first and often won't get to "normal" 98.6 F until around 6 months of life.  This was absolutely true for us, and like clockwork, as soon as little J hit 6 months he wasn't a little lump of coal anymore!

3.  Circumcised baby boys need their smegma cleaned to avoid penile adhesion
So if you have a circumcised baby boy, this is very important information and I feel also sorely unadvertised.  Around the base of the head of the penis, where it meets the shaft, dead skin cells collect and create this white sticky substance called smegma.  You need to clean this stuff out or it can cause the head of your son's penis to become stuck to the shaft, which is called a penile adhesion.  If left untreated, it can get to the point where it needs to be surgically corrected.  I've found this easiest to do when you have your baby boy in the bath, and dad can distract him with toys, etc.  Just take your little washcloth, pull down gently on the shaft skin of the little penis so that you can see the rim of the head, and VERY GENTLY wipe away the white smegma.

4.  Your baby needs a Vitamin D supplement if he is exclusively or primarily breastfed
Vitamin D is necessary for the absorption of calcium, so if your baby doesn't get enough Vitamin D, he won't absorb enough calcium and can develop a bone malformation condition called Rickets.  The American Academy of Pediatrics currently recommends that babies who are exclusively or primarily breastfed (less than 32 oz of formula per day) be given 400 IU of Vitamin D daily.  This is because Vitamin D does not pass through breastmilk very well, and most babies do not (and should not) get enough sun exposure without sunscreen for their bodies to produce adequate Vitamin D.  We like to use D Vi Sol (1 ml) mixed in a 2 oz bottle of expressed breastmilk or formula.  You can get higher concentrated products that only use one drop, but the chance of overdose is higher with these products.

5.  Even a mild sunburn is serious during the first year of life and requires evaluation by a physician
So if you are tempted to take your baby out for some sun-bathing to get their Vitamin D after reading #4, don't.  Even a very mild sunburn during the first year of life is serious and requires evaluation by a physician.  Not to mention the risk of melanoma later in life is exponentially increased if your baby's delicate skin gets burned.  In the past, the American Academy of Pediatrics didn't recommend using sunblock on babies under 6 months of age, but because of the risk of skin cancer, they have revised their guidance and now recommend using sunblock on babies from birth.  And just because your baby is in the shade does not mean she won't get burned.  Even the UV rays reflecting off other objects can burn baby's skin, so apply, and reapply, that sunblock!  I recommend Banana Boat Baby Sunblock because it has a great "no tear" formula, unlike some other baby sunblock products.

6.  Don't take your calcium supplement with your prenatal vitamin
Calcium competes with iron for absorption, and calcium wins.  So if you are taking your calcium supplement at the same time as your prenatal vitamin (or taking your prenatal vitamin with a glass of milk), you won't absorb the iron.  This is important because iron deficiency causes anemia, which is a reduction in your red blood cells' ability to transport oxygen.  Anemia is common during pregnancy and in breastfed babies, so make sure you are taking that calcium and iron separately (my pharmacist friend said about 4 hours in between, but if that's not possible for you, even an hour will help).  This also applies if your doctor has prescribed an iron supplement for your baby.  Make sure you don't give it to her in a bottle of milk because she won't absorb it.

7.  Babies should not get any fluoride until 6 months
Fluoride is important to prevent tooth decay, but like anything, too much of a good thing isn't good.  In the case of fluoride, too much can lead to fluorosis which is permanent stains and softening of the tooth enamel.  Teeth developing under the gums are the only ones at risk of fluorosis (once they have erupted, they are no longer at risk).  Therefore, the ADA (American Dental Association) suggests that for the first 6 months of life, babies do not receive fluoride.  If your baby is exclusively breastfed, you don't need to worry (it does not pass into the milk).  If your baby drinks formula, and you use the powdered stuff, you need to buy fluoride free bottled water to mix it (or use a reverse osmosis filter at home that removes fluoride).  I like Gerber Pure Water.

8.  Babies need fluoride after 6 months
So after 6 months of age, babies need .25mg of fluoride daily to help reduce tooth decay.  To get this, at 6 months your baby should start drinking 4-6 oz of fluoridated (0.7 ppm) water per day.  You can either find out how much fluoride is in your local water source, or I like to use Nursery Water with added fluoride.  You should still prepare formula with fluoride free water to ensure that your baby isn't getting too much fluoride per day.

9.  Babies should start drinking water at 6 months
Prior to 6 months, babies get plenty of water from their formula or breastmilk.  The act of drinking burns calories, and young babies need all the calories they can get.  If they burn calories drinking water, those calories aren't being replaced with anything.  Once your baby is 6 months and is eating solid food, they should be getting 4-6 oz of fluoridated water daily.

10.  All formula is created equal
All formula must meet the same FDA nutritional requirements, so name brand is no better than generic when it comes to feeding your little one.  And if you like a certain name brand, most generic formula brands make a generic version of that kind (e.g.  Parent's Choice Advantage is the generic of Similac Advance).  So if you choose generic to save money, know that what you are feeding baby is just as good as that expensive brand-name stuff.

11.  Making your own baby food may expose your baby to more pesticides than store-bought
Baby food farmers/manufacturers must meet stricter requirements than those that grow produce sold fresh.  Therefore, making your own baby food may actually expose your little one to more pesticides and contaminants than if you just buy the store bought stuff.  Additionally, stage 1 baby foods don't contain any preservatives or additives, and many stage 2 and 3 don't either.  So while there's nothing wrong with making your own baby food, if you are doing it to try to be more healthy, you may be doing all that extra work for nothing.

12.  "Natural" and "homeopathic" remedies are not as safe as they claim
Just because something is "natural" or "homeopathic" does not mean that it is safe.  In fact, natural and homeopathic remedies are not regulated by the FDA, which means that they don't have to meet any safety or efficacy requirements, nor conduct any clinical trials to prove safety or efficacy like conventional medicines do.  Additionally, production is not standardized, causing variability in potency and purity.  And labeling is not regulated, so producers of homeopathic and natural remedies can make any claims that they want without the requirement of evidence to back it up.  A key example of one of these potentially unsafe products is Hyland's Teething Tablets.  These "all natural" "homeopathic" tablets contain an ingredient called belladonna, which is a known neural toxin.  The FDA actually pulled Hyland's Teething Tablets off the market for a period of time after receiving reports of serious adverse reactions and after conducting tests on the tablets which showed inconsistent amounts of belladonna in the tablets.  While the tablets are back on the market, they still contain belladonna, and therefore I wouldn't give them to my baby.  I have a friend who swears by them, though.  She calls them "baby crack."  Unfortunately, that may not be too far from the truth if the tablets are altering her baby's neural state.  And just because one mom uses a homeopathic or natural remedy and their baby is fine doesn't mean yours will be.  That's why during clinical trials of conventional medications, only some people have serious side effects.  Different things affect different people differently.  So just remember, just because it's natural, doesn't make it safe.  Just ask my dog who had to get his stomach pumped and spend the night at the emergency vet after he ate some "all natural" mushrooms growing in the back yard!

13.  Only use a cool-mist humidifier in your baby's room
I hate this one because I hate cool mist humidifiers!  They get everything around them all wet, leave a white powder all over every surface, and you have to disinfect them every single day!  However, the reason you can only use cool-mist humidifiers in your baby's room is because a warm mist one will make the air hot and stuffy, and these conditions increase the risk of SIDS.  And of course, when baby gets bigger and is mobile, warm mist increase their risk of burns.

So there you go!  I hope you found this information helpful and enlightening!

1.  Baby 411, 5th Edition, Denise Fields and Dr. Ari Brown
2.  Brent Steadman, M.D. (my pediatrician)
3.  Taking Care of Your Child, 8th Edition, Robert Pantell, M.D., James Fries, M.D., and Donald Vickery, M.D.


  1. I love this list! These great things to know. By the way, we recently (unwillingly, too) made the switch to a cool mist humidifier, and I read that if you use distilled or filtered water, you don't get any white dust. We just pour water in from our Brita pitcher and haven't had any problem. So maybe that will help!

  2. We had a lot of trouble with the Vitamin D at first. He would spit it up and I swear it was making him gassy. Since it was summer and we we spending a lot of time outside so the Dr. said I could lay off for a while. As soon as we moved back indoors for the winter (and his gastrointestinal tract was more advanced) I started giving them again, This time he loves it! You know the old adage - if at first you don't succeed....