Wednesday, January 20, 2010

My baby has ACNE!

Neonatal Acne
This usually appears after a few days after birth. You will notice small papules usually on the nose, cheeks of full term infants. This is a normal response to mother's hormones which stimulate the glands on the face. You do not have to do anything because this resolves spontaneously by 4 to 6 months of age. Just clean face with plain water. Do not put any lotions, soaps on the area. This might just irritate your baby's face.

Tuesday, January 19, 2010

My Newborn Has a Rash

Erythema Toxicum
This rash usually appears after 24-48 hours after birth and can appear up to the 10th day of life. This is a benign and self-limiting condition with the cause unknown. This was called as "flea bites of the newborn"because it is very similar to how flea bites look like. The rash are usually 2 to 3cm in diameter and you can have vary from a few lesions to a hundred and when you look closely you will see a central pustule or papule. This can be found on the face, arms, back, chest and abdominal area. The palms and soles of the feet are spared. This usually resolves in 5-7 days of age and no treatment is necessary.

Friday, January 8, 2010

Doctor My Baby has an "outie"!!

We often hear parents tell us that their baby has an outie and grandmother would recommend putting a coin on the umbilicus to strap it down to help make this better. An outie is a bulge on the umbilicus which is more prominent when the baby cries, coughs or strains. We call this an"umbilical hernia". This is due to the imperfect closure or weakness of the muscles in the umbilical ring. The size of the defect ranges from 1cm to 5cm but larger ones are rare. Most umbilical hernia that appear before 6 months of age will resolve by 1 year of age. Even large ones at 5-6cm spontaneously resolve by 5-6 years of age. The chances of the intestinal contents be trapped through the defect is rare. Surgery is only indicated if the defect progressively becomes large after the age of 2 or if this is greater than 2cm big. This is less likely to resolve spontaneously and if it persists by the age of 3-4 years old. The other indication for surgery is that if the hernia is strangulated. So now we now know that putting a coin on the umbilicus would not help in the treatment of an umbilical hernia.

Tuesday, January 5, 2010

Childproofing Checklist

  • first things first get all the poisonous substances(detergent, bathroom cleaners...) and put on higher ground (so children can not reach)
  • make sure the sharp edges of the tables and corners are protected by edge bumpers
  • door stops and door holders are essential
  • do not put the cribs close to the blinds with the strings hanging, babies can get strangulated on these cords
  • smoke detectors (make sure you have one at each level of the house)
  • all swimming pools at home should be gated accordingly adhering to the federal standards
  • safety latches and locks (especially for the kitchen and the bathroom cabinets and drawers)
  • safety gates (preferably the ones that screws on the walls)
  • window guards(bars in guard should not be more than 4 inches apart)-make sure you have a window that can be used as a fire escape
  • outlet covers (make sure you get the ones that the child can not remove)
  • carbon monoxide detectors
  • when you visit someone or when you have visitors, make sure all the purses are out of reach (they can have a different kinds of medications in their purse that you do not want your child to get into)

Once everything is in place the last thing you need to do is get down on your knees and crawl all over the house to see what else your child might be interested in to get to it and do something to make your house safe. Try to do the childproofing of your house as early as 4-6 months of age and re-evaluate every few months to see if it is still effective protection according to your child's developmental stage. Remember children can outgrow the way you childproof your house. Re-evaluate from time to time.

Head Injury

Once your child turns 6 month to 5 years of age you need to be very careful about minor head injuries. Babies' heads are a little bit big compared to their bodies so basically they are top heavy. Their coordination is not very good but they are very brave and go were no adult would boldly go because they do not know better. Most minor head injury in infants and young children are preventable and close adult supervision can not replace any state-of-the-art childproofing equipment that you might use.

What are the signs and symptoms of a mild head injury?
  • child crying but consolable
  • minor scalp swelling
  • minor cut or laceration of the scalp
  • mild headaches
  • vomiting 2 to 3 times

What are signs and symptoms of a potential serious injury?

  • crying non-stop and inconsolable
  • on feeling the scalp area you might feel a cracking sound there might be a fracture
  • blood or clear fluid coming from the nose or ears
  • obvious serious wound i.e. a big laceration or swelling
  • seizures
  • loss of consciousness
  • vomiting more than 2-3 times after the injury
  • changes in behavior such as increased sleepiness, agitation, confusion or sluggishness
  • headaches are getting worse

Call you doctor or 911 if you see any of the signs and symptoms of a potential serious injury.

Prevention is the Key:

  • avoid letting your baby sleep on the bed (they tend to roll over and fall), I can not but emphasize this so many times but still a lot of the parents are letting toddlers/infants sleep with them.
  • do not use walkers (they become a little more mobile than what their development can handle so they tend to pull on things resulting in furniture falling on them), they tend to fall on steps (it is actually a good thing here in Arizona that we mostly have 1 story houses with no basements)
  • childproof the house
  • can not emphasize more the need for close adult supervision ( the most important tool is prevention) but sometimes those babies are pretty quick just a few seconds that you do not look at them, accidents happen.