PRACTICAL PEDIATRICS

811 Ira E. Woods

Grapevine, Texas76051

817-481-3585

BABY-SITTING REMINDERS

The following list of information should always be left with a babysitter:

Parents phone numbers

Neighbors phone numbers

Doctor

Fire/Rescue

Police

Poison center

Home phone

Home address

Parents Should:

*Meet the sitter and check references and training in advance.

*Be certain the sitter has had first aid training and knows CPR.

*Be sure the babysitter is at least 13 years old and mature enough to handle common emergencies.

*Have the sitter spend time with you before babysitting to meet the children and learn their routines.

*Show the sitter around the house.
*Point out fire escape routes and potential problem areas. Instruct the sitter to leave the house right away in case of fire and to call the fire department from a neighbor's house.

*Discuss feeding, bathing, and sleeping arrangements for your children.

*Tell your sitter of any allergies or specific needs your children have.

*Have emergency supplies available including a flashlight, first aid chart, and first aid supplies.

*Tell the sitter where you will be and when you will return.

*Be sure any guns are stored unloaded in locked cabinet.

Sitters Should:

Be prepared for an emergency.

*Always phone for help if there are any problems or questions.

*Never open the door to strangers.

*Never leave the children alone in the house - even for a minute.

*Never give the children any medicine or food unless instructed to do so by the parents.

*Remember that their job is to care for the children.

*Tender loving care usually quiets an unhappy child.

Last Updated

12/9/2009

Source

TIPP—The Injury Prevention Program - American Academy of Pediatrics

PRACTICAL PEDIATRICS

811 Ira E. Woods

Grapevine, Texas76051

817-481-3585

GOING BACK TO WORK AND SUCCESSFYLLY CONTINUING TO BREASTFEED

Women everywhere are successfully combining breastfeeding and working. Advanced planning, family and workplace support, and a high quality breast pump make it work for working moms. The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months. The longer babies are breastfed, the greater the health benefits for both mom and baby. Breastfeeding is good for your employer too – it reduces absence from work for baby’s illnesses.

Benefits of Breastfeeding
For Baby / For Mom
Breastfed infants have fewer and shorter episodes of illness / Convenient and always ready for baby
Nutrition provided by breast milk benefits you on baby’s IQ / Benefits the overall health of mothers
Reduce the risk of obesity and hypertension / Just the right temperature, and is the healthiest choice at the least cost
Helps the baby’s immune system mature / Increases the rate of weight loss in most mothers
Increases the effectiveness of immunizations / Breastfed babies are healthier, and mothers miss less work and spend less time and money on pediatric care
Protects against developing chronic diseases
…there are many other benefits to breastfeeding
Go to to see references and find more.

You and Your Milk Supply

Your milk supply is established in the first days after birth. You should breastfeed your baby frequently to help produce lots of milk. Enjoy the time after your baby is born to rest and regain your energy. It is recommended to avoid bottles when you and baby are together. You may begin offering small bottle feeds when the baby is 3-4 weeks old to help him get used to bottles and once breastfeeding is well established.

Once you are back to work, flexible scheduling, telecommuting, and job sharing can help. Breastfeed your baby before you leave for the day. Some moms fit in one last breastfeeding at daycare provider. Breastfeed as soon as you are together again at the end of the day. While you are at work, plan three 15-minute pumping breaks during each 8-hour workday. If your shift is longer than 8 hours, try to add another short pumping session. Double pumping cuts down pumping time, but it is important to pump for 12-15 minutes during each break. Mothers can pump into the same bottles at different pumping sessions on the same day as long as the milk is kept chilled.

Breastfeed of the in the evenings and learn how to breastfeed lying down while you rest. Nighttime breastfeeding boost your supply! If your supply is low, breastfeeding or pumping more often is the simplest way to increase supply.

Choosing the Right Pump & Accessories

It is important to select the best breast pump and accessories for your work situation. Many working moms choose Freestyle Pump in Style Advanced or a hospital-grade breast pump such as Symphony. These pumps offer superior performance, comfort and convenience. Medela pumps have vehicle lighter adaptors and battery packs for convenience. Call 1-800-TELL YOU for a local rental location or visit

Choosing a Childcare Provider for your Baby

Choose a childcare provider you trust who is comfortable caring for your breastfed baby. You can also check with your state or county for a list of licensed childcare providers. By choosing a childcare provider that is close to your workplace, you can visit your baby and breastfeed during lunch.

First Week of Work

It can be overwhelming for a new mom to begin work. Start slowly, with a few hours or a half-day, beginning mid-week. It is normal to feel tired at first. On days off, nap with your baby. Enjoy your time together, and breastfeed often. Protect your milk supply by pumping often while away and breastfeeding when you are with your baby. Avoid becoming overly full, as engorgement sends a signal to your body to slow milk production down. You may find it helpful to have the support of another pumping mom to talk to.

Pumping at Work

The milk you pump at work one day is used the next day to feed your baby. Store your milk in Medela’s BPA- free breast milk collection bottles or in disposable bags specifically designed for breast milk, such as BPA-free Pump & Save Bags, by Medela. Frozen milk can be stored in 1-3oz. containers and thawed when needed to use as back-up supply. After pumping, cool your milk in a refrigerator or cooler. Use a cooler carrier with frozen ice packs to transport your milk from work or to your daycare provider.

Breastmilk Storage (For Healthy Term Babies)
Room Temperature / Cooler with 3 Frozen Ice Packs / Refrigerator / Self-contained Refrigerator Freezer Unit / Deep Freezer
Freshly expressed breastmilk / 4 hours at 66-72F (15C) / 24 hours at 59F (15C) / 5-7 days at 32-39F(0-4C) / 3-4 months / 6-12 months at 0F(-19C)
Thawed Breastmilk (previously frozen) / Do not store / Do not store / 24 hours / Never refreeze thawed milk / Never refreeze thawed milk

If you travel for work, milk can be shipped packed in dry ice, or shipped on airlines packed in cooler containers with dry ice packs. Check online to see what the rules and regulations are for your local airport.

Medela offers breast pumps that are ideal for pumping at work. The Freestyle and Pump in Style Advanced include everything you need to double pump in convenient carry bags and feature 2-Phase Expression for more milk in less time. In addition, Freestyle is uniquely small and light weight and includes accessories for optional hands-free pumping.

Here are some other tips for at-work pumping: Two-piece clothing that opens easily at the waist makes pumping easier. Some moms have two (2) pump kits, one (1) for home use and parts after pumping, some moms refrigerate their pump parts and reuse. They save washing parts until they return home. Medela’s Quick Clean Micro Stream provides handy easy clean-up in the workplace.

Updated 6/10

PRACTICAL PEDIATRICS

811 Ira E. Woods

Grapevine, Texas76051

817-481-3585

PEACE OF MIND

IRON AND ZINC FOR YOUR BODY

Nursing mothers want their babies to have the best – and breastfeeding is best.

More than just nutrition

  • Breast-fed babies have fewer bouts of diarrhea, and fewer and less severe ear, respiratory, and urinary tract infections.
  • Breast milk aids your baby’s eye and brain development.
  • Breastfeeding lowers your baby’s risk of developing allergies and certain chronic diseases – and your risk of breast cancer.
  • Breastfeeding may decrease your baby’s risk for obesity later in life.
  • On average, breast-fed babies score better on IQ tests than formula-fed babies.
  • Breastfeeding teaches your baby to like the flavors served at your family’s table long before her first bite of solid food.
  • Breastfeeding teaches you to honor your baby’s appetite – feeding when she/he is hungry and stopping when she/he “says” she/he had enough.
  • Your baby will enjoy these wonderful benefits as long as you continue to breastfeed.

Infants and children under 2 years of age are at risk of iron and zinc deficiencies because they typically eat few foods rich in these essential nutrients.

Talk with your doctor about continuing to breastfeed throughout the first year, as your baby makes the transition from an all-milk diet to one that includes a variety of other nutritious foods.

AND BODY

BREASTFEEDING YOUR BABY

Did you know that:

  • Around the time your baby is ready for solid foods, her/his need for nutrients (like iron and zinc) may begin to outpace the supply from either her body stores or your breast milk.
  • The negative effects of iron deficiency during infancy – developmental delays, lower IQ scores, challenging behavior – can continue into later childhood.
  • Reduced appetite, slow growth and frequent diarrhea can be signs of zinc deficiency. Talk with your doctor is you have concerns.
  • Breast milk + iron-fortified cereal protect babies from anemia better than iron-fortified formula alone.
  • Pureed meats are well-tolerated by infants ready for solids and an excellent source of iron and zinc.
  • Starting solids is a process, not a single event. Continue breastfeeding as long as you can.
  • Preparing your baby’s cereal with breast milk can help your baby learn to enjoy the first solid food.

Infants at risk of iron deficiency:

Pre-term and low birth weight, infants BN to Anemic mothers who smoke, adolescent mothers, low income mothers, minority women, immigrant families with low iron diets, infants fed: low iron formula or cow’s milk, low-iron diets, older infants after a period of exclusive breastfeeding.

Introducing single grain cereal when your baby:
*Doubles birth weight and weighs at least 13 pounds.

*Seems hungry after 8 to 10 breast feedings a day or drinks 32 ounces of formula a day.

*Sits with support and has good head control.

Introduce multi ingredient cereals when your baby:

*Has tried a variety of single ingredient Gerber 1st baby food.

Starting cereal tips:

*Cereal is an excellent first choice because it is easy to digest.

*Start with single ingredient, iron and zinc fortified Gerber rice cereal.

*Each serving of Gerber cereal provides 45% of the daily value for iron and 20% for zinc.

*Alter your baby’s cereal consistency by varying the amount of liquid added.

*Always feed from a spoon do not add cereal to a bottle.

12/09

PROTECT YOUR HOME AGAINST FIRE…

PLANNING SAVES LIVES

Protecting your home against fire involves planning. There are precautions you can take that can help you protect you and your family.

*Never leave small children alone in the home, even for a minute.

*Install smoke alarms in furnace and sleeping areas. Check batteries once a month.

*Plan several escape routes from the house. Plan a place to meet right after leaving the house.

*Conduct home fire drills.

*Do not smoke in bed.

*Dispose of cigarette butts, matches, and ashes with care.

*Keep matches and lighters away from children.

*Be sure your gas water heater is off the ground. Spilled flammable liquids will be ignited by the pilot light.

*Do not clean clothes with flammable liquids.

*Place a barrier around open flames.

*Do not wear loose-fitting clothing near a stove, fireplace, or open space heater.

*Have your heating system checked and cleaned yearly.

*Check electric appliances and cords regularly for wear or loose connections.

*Use only 15-ampere fuses for lighting circuits. Never use a substitute for a fuse.

*Place fire extinguishers around the home where the risk of fire is greatest – in the kitchen and furnace room, and near the fireplace.

In Case of Fire

*Get everyone outside right away. Go to your planned meeting place.

*Do not stop to dress or put out the fire. (Most deaths occur from suffocation due to hot fumes and smoke, not from direct burning.)

*Call the fire department from a neighbor's house.

Last Updated

11/30/2009

Source

TIPP—TheInjuryPreventionProgramAmericanAcademy of Pediatrics)

PRACTICAL PEDIATRICS

811 Ira E. Woods

Grapevine, Texas76051

817-481-3585

SKILLS YOUR CHILD SHOULD DEMONSTRATE

MOTOR SKILLS / SPEECH AND LANGUAGE SKILLS
0-3 Months / 0-3 Months
*Symmetrical arm and leg movement / *Quiets to a familiar voice
*Gains head control in supported sitting / *Attaches to nipple and sucks
*Props on forearms when lying on tummy / *Makes gurgling
*Follows with eyes a moving person or toy / *Smiles
*Cries to express hunger, fear, and discomfort
3-6 Months / 3-6 Months
*Explores objects with hands and mouth / *Babbles and demonstrates sound play
*Brings hands together in the middle / *Turns head toward source of the sound
*Rolls from tummy to back / *Puts toys to mouth
*Reaches for toys and may grasp them / *Rice Cereal trials
*Lifts head and chest from floor to tummy
*Sits with some support
*Holds a bottle with two hands
6-9 Months / 6-9 Months
*Sits independently with active reaching / *Waves in response to “bye-bye”
*Picks up tiny objects / *Duplicates syllables such as “dada, mamma, or baba”
*Stands with help / *Shakes and bangs objects in play
*Rolls from back to tummy / *Reacts to a “peek-a-boo” game
Moves an object from hand to hand
9-12 Months / 9-12 Months
*Bangs tow cubes / *Gives objects upon request (“Give me…”)
Cruises and pulls up onto furniture / *Says “mama/dada” meaningfully
*Takes objects out of container / *Imitates non speech sounds (moo, vroom-vroom)
*Crawls on hands and knees / *Responds to “no-no”
*Attempts to use a spoon / *Says first word
*Enjoys toddler swings / *Drinks from a cup/experiments with finger foods
12-18 Months / 12-18 Months
*Places one block on top of another / *Uses/plays with objects appropriately (phone,etc)
*Walks independently / *Follows simple 1 step commands
*Scribbles on paper / *Attends to pictures in a book
*Tosses a ball forward / *Uses spontaneous words
*Polks with index finger / *Shakes head “no” r or uses “no” as favorite word
*Enjoys playing a sandbox / *Identifies two body parts on self (eye, nose, mouth)
*Places pegs in a pegboard / *Participates in play routine for 1-2 minutes
18-24 Months / 18-24 Months
*Circular scribbles / *Points to common objects
*Stands on one foot with help / *Understands a minimum of 50 words
*Picks up toy from floor without falling / *Asks for “more”
*Attempts to fold paper / *Asks “What’s that?”
*Kicks ball forward / *Imitates words readily
*Imitates housework during play / *Uses 5-10

PRACTICAL PEDIATRICS

811 Ira E. Woods

Grapevine, Texas 76051

817-481-3585

SORE NIPPLE MANAGEMENT

Prevention & Treatment

Breastfeeding is meant to be a comfortable, pleasant experience. Most of us have heard stories of sore nipples. You can avoid this problem most of the time. However, many new mothers still find their nipples are tender for the first few days when the baby starts nursing. This usually disappears by 1-2 weeks.

CAUTION: blisters, cracking, bleeding and/or pain that continues during or in between feedings is not normal. Check with a lactation consultant, La Leche League, or Nursing Mother’s Council if you have any of these problems.

Prevention: To prevent nipple tenderness, start with correct positioning and latch on:

Cradle Position:

  • Place a pillow or two in your lap to support your baby.
  • Place your baby’s head on the crook of your arm.
  • Make sure your baby is turned towards you chest-to-chest at breast level
  • Once body is in correct position proceed with the following steps:

A.Support your breast with your hand in a “L” or “C” position, thumb on top of breast, fingers below away from areola.

B.Tickle your baby’s lips until he/she opens WIDE, and then quickly pull him onto your breast. Be patient. This may take a minute.

C.Make sure your baby’s lips are behind the nipple, encircling the areola.

Football/Clutch Position:

  • Put a pillow or two at your side to help support your arm and your baby.
  • Support your baby’s back of his head in your hand, with your forearm supporting his upper body against your side.
  • Follow steps A, B, C under Cradle positions.

Lying Down Position:

  • Lie on your side with pillows supporting your back and your top leg, which is forward.
  • Place your baby on his side facing you.
  • Follow steps A, B, C under Cradle position.

Vary nursing positions for the first week.

Breastfeed frequently, every 2-3 hours (8-12 feedings per 24 hours). Keeping your newborn baby on an artificially longer schedule may make him/her frantically hungry and increase the likelihood that too vigorous nursing will make your nipples tender.