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Infant Health: Milestones, Vaccines, Diet & More

Dr. Leslie Deitch-Noble May 29, 2014 11:00 AM This chat has ended. Thank you for participating.
Brenna (Moderator) - 10:27 AM:
Our online medical chat Infant Health: Milestones, Vaccines, Diet & More with Dr. Leslie Deitch-Noble will begin at 11 am. You can submit questions in advance or at any point during the chat.

Brenna (Moderator) - 11:00 AM:
Thank you for joining us. Our chat Infant Health: Milestones, Vaccines, Diet & More will begin shortly.

Matt (Chicago, IL) - 11:01 AM:
What is the most important steps for a parent to take to provide the best care for the new infant baby?

Dr. Leslie Deitch-Noble (NorthShore):
One super important step is making sure you select a pediatrician for the baby and that you are comfortable with that person. They will help guide you every step of the way, in terms of feeding, sleep, milestones, signs of illness, etc. Another key component is learning to trust your instincts - even though having a newborn is very overwhelming, most parental instincts are correct. Finally, making sure that the baby's caretakers (especially mom) are taking care of themselves, getting rest, minimizing stress is also super important.

Cheyenne (Waukegan Illinois) - 11:05 AM:
If your child was born prematurely, what are the health risks?

Dr. Leslie Deitch-Noble (NorthShore):
Good question. However, the answer is extremely varied, mainly dependent on how premature the baby was born. A baby born at 25 weeks gestation will likely have more potential issues than a baby born at 34 weeks gestation (full term being 40 weeks.) Sometimes babies born prematurely just need extra time in the hospital to grow. However, sometimes there are other issues (again, especially with more "extreme" prematurity), such as respiratory issues due to lungs that haven't fully developed, vision problems (due to lack of maturation), neurologic problems, etc. As far as developmental milestones, we give all premature babies until 2 years of age to "catch up" to their peers. So, at every visit with your pediatrician, they will always take the baby's gestational age into account when assessing growth and development.

Andrea (Chicago) - 11:11 AM:
When should babies visit the dentist for the first time?

Dr. Leslie Deitch-Noble (NorthShore):
Great question. All children should see the dentist for the first time by age 3. Most "family" dentists will begin seeing children at 3 years of age. However, if there are any issues that arise with the teeth earlier than 3, they can see a pediatric dentist sooner. As soon as teeth first appear, you should begin cleaning them - you can start just by wiping down the teeth and gums with a washcloth when in the bath. Then, around age 12-18 months, use a soft toothbrush or finger brush. You can start with just water and add "training" (fluoride free) toothpaste as time goes on.

Gina - 11:14 AM:
Does supplementing breast milk with formula negate the health benefits of breastmilk? Woudl it be better to try to increase output with medicines?

Dr. Leslie Deitch-Noble (NorthShore):
The baby will still get ALL the benefits of breast milk even if they get some formula supplementation, in addition. For some nursing moms, Fenugreek (an herbal supplement) can sometimes help increase milk supply - to an extent. If you are having trouble breast feeding or with milk supply, another good option would be to work with a lactation consultant - your pediatrican can refer you to someone who can come to the home or some meet in small groups.

Jean (Evanston) - 11:17 AM:
When can you move your child to a toddler bed? Are there certain signs to look for? Safety concerns?

Dr. Leslie Deitch-Noble (NorthShore):
Usually the earliest that children are ready for a toddler bed is 18 months of age. That said, some babies stay in their cribs until age 3. It just depends on the child. Once the crib is on the lowest setting and the child can still climb out, it is probably time to switch to a toddler bed. (The babies that stay in their cribs longer are usually those that don't try to climb out!) Sometimes, even if the child isn't a climber, parents will switch over if a new baby is on the way and they don't want to get an extra crib. But, average age to make the switch ranges between 18 months and 3.

Beth (skokie) - 11:21 AM:
I;ve heard mixed opinions on vaccines. Are the preservatives in them really safe? Is it better to give one per visit for a baby's immune system? What about delayed schedules? thanks

Dr. Leslie Deitch-Noble (NorthShore):
Vaccines are extremely safe - and extremely important. The vaccines, themselves, and the preservatives in vaccines have been extensively studied and there are NO associated health or developmental concerns. We, as pediatricians, do NOT recommend a delayed or slow schedule (ie, 1 per visit.) Reason being, the longer vaccines are delayed, the more at risk your baby (and other babies in the community) are to contract vaccine-preventable diseases, such as whooping cough or measles (which have both become more prevalent lately due to vaccine refusal / delay.) Further, we do not know if vaccines are as effective given at different ages and intervals than how they were designed. For accurate information, check out these websites: CDC.gov, ecbt.org (every child by two), vaccinateyourbaby.org. Finally, ask your pediatrician their opinion - and I think you'll get a similar answer... and ask what they would do for their children or loved ones (I know my answer - vaccinate!... on time!)

erin (evanston) - 11:29 AM:
why does my pediatrician say that a fever is a good thing? my 7 month old had a 102.8 fever recently and he told me not to go to the er since they weren't other symptoms. what is considered too high?

Dr. Leslie Deitch-Noble (NorthShore):
A fever is a sign that your child's immune system is working to fight off an infection, which is probably why your pediatrician says it's a "good thing" (meaning, your baby's immune system is doing what it should.) And, a fever, itself, will NOT harm the child. There is no number that is a cut off for "too high." Some kids will have 104 degree temps and be running around and playing. It's more important to assess the child's overall condition vs just the number (for example: are they urinating at least 3 times per day?, are they waking up for feedings?, are they lethargic?, are they inconsolable?) The only exception to this is for babies UNDER TWO MONTHS of age. In that age range, any temp over 100.4 is considered a fever and they should be seen by a doctor immediately. The reason is that under 2 months, the baby's immune systems are not as well developed and they are at risk for more serious infections vs older babies.

Colleen (Buffalo Grove) - 11:34 AM:
I cannot get my 4mo daughter to nap unless she is being held or in her swing. The minute I lay her down in her crib she wakes up. I want to transition her the the crib. Help!

Dr. Leslie Deitch-Noble (NorthShore):
Good news and bad news with this one... The good news is that 4 months of age is a perfect time to sleep train babies. The bad news is that sleep training is hard - much more so on parents than babies. At this age, babies should be learning to go to sleep on their own - this means, they should be sleeping in their own crib and be put down to sleep awake (drowsy is okay, but not asleep.) They should not be fed until they fall asleep. This all holds true for naps and for sleeping at night. So, we have to teach babies this new "skill." The way to do this is to let her self soothe to sleep and, unfortunately, this involves some crying as she makes the transition. But, even though she may cry for 30+ minutes - usually after 3-4 days of consistent sleep training, it's done! And, everyone is sleeping well. Check out either Dr. Weissbluth's sleep book ("heatlhy sleep habits, happy baby") or Dr. Ferber's book.

Jessica - 11:40 AM:
At how many months should you start to be concerned that your child isn't crawling? Or is crawling in a way that is strange and not really conducive to moving toward walking etc?

Dr. Leslie Deitch-Noble (NorthShore):
Great question. Babies usually "crawl" sometime between 6 and 9 months of age. I put "crawl" in quotations because sometimes it is not a classic, hands and knees crawl. Many babies will do an "army" crawl or only crawl backwards or in circles or some other variation. And, some babies skip crawling all together and move right onto walking (or learn to crawl and walk all in the same week.) As long as the baby is hitting all other developmental milestones as he/she should, it's not a big concern.

Ellyn (Highland Park) - 11:44 AM:
Is infant eczema associated with allergies? What is the best way to treat it?

Dr. Leslie Deitch-Noble (NorthShore):
Infant eczema can be associated with allergies, but is not necessarily always (or even usually the case.) It is more likely to be associated with allergies if there is an immediate family member (parent or sibling of the baby) with food allergies, seasonal allergies, asthma or eczema. The treatment depends on the severity of the eczema. If it's fairly mild, usually using a good, thick moisturizer (such as aquaphor, vaseline, cerave, or eucerin cream) twice daily - especially after bathing when the skin is still moist - is all you will need. If it is more severe, your pediatrician may prescribe topical steroids to be used as needed for flare-ups, in addition to using moisturizer. If it is severe eczema, it is important to use these topical medications as directed so that the baby isn't uncomfortable and scratching a lot, as this will can lead to the areas getting infected if the skin is broken open.

Brenna (Moderator) - 11:46 AM:
There are 15 minutes left in our chat. Please submit your final questions.

Cris (Skokie) - 11:50 AM:
Is one pain killer better than another for my infant? Does it make a difference what I give? When should I give my child the children's version vs the infant one?

Dr. Leslie Deitch-Noble (NorthShore):
For babies under 6 months, you should only use Tylenol (or the generic, Acetaminophen.) Once over 6 months, you can use either Tylenol or Ibuprofen (which is the same as Motrin or Advil.) The one advantage of ibuprofen is that it lasts a bit longer so you don't have to give it as frequently. The question about the difference between infant's and children's is a great one. About two years ago, the makers of Tylenol/Acetaminophen made it so their "infant's tylenol" and "children's tylenol" are actually the exact same concentation - so the dose is the same regardless of which one you have. However, with Ibuprofren, the infant's version is a different (smaller) dose than the children's, as the infant's is more concentrated. Bottom line, is when you go to your pediatrician for a visit, check which one you have at home and make sure they recommend the correct dose.

kelly - 11:55 AM:
how do i know if my baby is hungry when she wakes up at night or just wants to be held? she often wakes up and nurses for a few minutes and goes back to sleep (she's almost 6mo now). should i start sleep training? is CIO okay?

Dr. Leslie Deitch-Noble (NorthShore):
At 6 months (or when they weigh at least 13 lbs), babies do not need to eat in the middle of the night. 6 months (or even earlier at 4 months) is a perfect time to sleep train. Crying it out is definitely okay. And, even though it is super hard (for parents) while it is going on, it is so worth it in the end - as everyone will be getting better sleep. And, uninterrupted sleep is better for babies' growth and development. If you are disciplined with CIO, it usually only takes 3-4 nights (days too, as you should do it for naps as well.) Some good resources to use are either Dr. Weissbluth's book or Dr. Ferber's book.

Brenna (Moderator) - 11:59 AM:
This will be our last question of the chat. We apologize if we were unable to get to your question. A transcript of the chat will be made available at the end.

Brenna (Moderator) - 12:00 PM:
Thank you for joining us. For further questions or to make appointment, contact Dr. Deitch-Noble by clicking Find a Doctor.

Dr. Leslie Deitch-Noble (NorthShore) - 12:01 PM:
Thank you all so much for participating - such great, thoughtful questions from awesome parents!
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