All mothers are always concerned over the growth of their baby, first-time moms most especially. One particular concern is giving water to a baby. Do babies need water? Will they benefit from having water between feedings?

Research has been done extensively over this issue. The conclusion has it that babies, especially newborns (0-3 months), do not need extra water. All the water that they would need, they get from their breast milk or formula. Newborns given extra water feedings suffer several problems.

Low weight – a newborn baby’s stomach can only accommodate about less than an ounce of fluids. If you give them water between feedings, the stomach will have less room for breast milk or formula which is essential for growth and development.

Jaundice – there is increased incidence of jaundice to newborn given water between feedings. Breast milk or formula milk aids in the passage of meconium (first stool) and helps lessen the duration of physiological (expected) jaundice. Prolonged jaundice causes lethargy and sleepiness to an infant, which is a sign of brain affectation.

Nipple confusion – if you plan not to give your baby formula milk, you will have a problem with latching later on. Your nipple is softer, more pliant and different in texture compared to those hard, semi-flexible silicone nipples.

There is also no need for concern over dehydration during hot summer months. Research conducted in Jamaica and India showed that babies exposed to temperatures almost as high as 40(C showed no signs of dehydration as long as they are given the right amount of breast milk or formula. You will only add extra water to your baby’s formula when there are signs of dehydration seen on your baby. Some mothers (and grandmothers) will say give her some Pedialyte, which is good. However, Pedialyte should be given under the recommendation of your baby’s pediatrician.

When will you need to introduce that extra water? When your baby is already 6 months old, can hold down her solid food well, and she can sit up straight. Water is better than juice, if you are concerned of having the cleansing benefits of water. Give the water in a sippy cup, and not in a bottle. Do not place any additives like sugar to make her finish the water you give her. If she did not get to finish the water, don’t force her to consume all. Her stomach may already be in full capacity. She may just throw up the precious milk she’s consumed. Remember, all the water that your baby will need is found in breast milk or formula preparation. As long as you’re feeding your baby properly, and she does not have any medical condition like diarrhea or high fever, she will not require any additional water for hydration.

As a mother, you always check the nappies of your baby every time they pass stool. Learning how to look into your baby’s poop will give you an idea of what to do with your baby’s current diet. It’s important to remember that your baby’s digestive system is still immature, so the slightest change on his diet can do some drastic changes in his bowel.

For first-time mothers, it would be important to always observe your baby, especially when you notice that he’s doing number 2. Always observe the consistency of your baby’s stool and note the number of times per day that he does so. A baby with no problems with bowel movement will just cry to be changed. Sometimes you will just smell it especially when he’s asleep. For a constipated baby, bowel movement is an entirely different matter.

A CONSTIPATED BABY HAS THE FOLLOWING SIGNS:

Marked straining whenever he passes stool. Sometimes, your baby will give a somewhat distressed cry almost immediately afterwards. This type of cry will be distinctly different from the regular cry your baby gives just for nappy change.

Stool hard and formed, pellet-like in shape and has a more distinct odor compared to normal stool.

You see minute specs of blood bright red in color because of anal tissue irritation.

Your baby’s stomach is somewhat hard and distended

Your baby passes stool 3 times a week or less compared to his normal bowel habit.

YOUR BABY’S CONSTIPATION MAY BE DUE TO:

1) The formula that he’s given. There are some formulas that can cause constipation. Before changing, always ask your baby’s pediatrician if you can change the type of formula that you will give to your baby. The protein molecules in formula, even if they are formulated for infants, are still quite bigger and somewhat harder to digest compared to protein molecules of breast milk.

2) Solid food. Some solid food can cause your baby to be constipated. Foods like banana, rice, apple, and toast can cause constipation. Familiar? Yes, these are the foods that your doctor advice you to consume whenever you have diarrhea. Rice would be hard to eliminate for it’s the first solid food that you give to your child: rice cereal. This is the safest food in terms of allergy which is why it’s the first solid food given.

3) Dehydration. Your baby may not be getting enough fluids. When this happens, your baby’s body responds by re-absorbing the water that should be included in the stool for easy elimination. The reabsorption happens in the large intestine where stool is normally formed. The stool will then be hard in form and difficult to pass due to lack of lubrication.

4) Medical condition: Your baby may be suffering from an undiagnosed medical condition. Hypothyroidism, celiac disease, and aganglionic megacolon are rare metabolic disorders that can cause constipation. These cases however are VERY rare. To make sure that your baby is not suffering from any of those metabolic disorders, describe the type, smell, and frequency of your baby’s stool when you go for a check-up and state your concern over your baby’s bowel habits.

WHAT YOU CAN DO

1) If you suspect that your baby’s formula is the cause, talk to your pediatrician before you change formula.

2) Give your baby some gentle exercise. Gently move your baby’s legs in a cycling motion. Passive exercise can increase your baby’s metabolism as well as the movement of your baby’s intestines. Increased motility can help the passage of stool through the large intestines.

3) If you’re baby is now able to hold down most solids better, ask your doctor if you can give your baby some prune juice. Talk to him about adding a small amount of bran in your baby’s cereal to increase the fiber of her diet. Try to see if you can give your baby some strained apricots, prunes, peaches, plums, and spinach. These foods known as bulk-forming foods that aid in increasing the size of the stool without compromising its liquid content.

4) A warm bath can help your baby pass stool easily. The warm water helps in relaxing the abdominal muscles. Give your baby’s abdomen a gentle circular massage while encouraging him to pass stool. When you see him making an effort, continue with the gentle circular massage until he’s finished.

5) You can increase the fluid that your baby consumes by giving him boiled water every now and then. When you’re feeding him solid food, help him by washing it down with a teaspoon of boiled water between spoonfuls. Sometimes, a particular food is the only one causing your baby to be constipated (which is why only a single type of solid food is given to your baby a week before introducing another one). All you have to do is give the food in lesser amounts but with increased frequency. If you’re giving 6 tablespoons of food twice a day, give him 2 tablespoons of the food 3 times a day. This way the bulk that your baby digests will be lessened.

If all of these options fail, ask your doctor to prescribe a laxative for your little one. Remember to follow the recommended dose to the letter. Do not lessen or increase the medication unless you are told to do so. Abuse of laxatives can only worsen the problem. Even if you’ve done your research, do not give your baby any laxatives unless ordered by the pediatrician.

WHAT IS COLIC?

Colic is a condition when a baby is observed to be crying inconsolably for several minutes or hours on end with no apparent reason. It occurs in babies regardless of their health condition. Most babies experience colic in the first 3 months after birth and start to “recover” by age of 9 months. It occurs so suddenly, and with no warning or precedent signs that it causes worry and eventually frustration on parents and caregivers.

WHAT CAUSES COLIC?

Doctors and researchers have yet to figure out why a baby gets colic. Inconclusive studies have yet to disprove the fact that colic is due to gas, but some evidence is seen that trapped gas is the primary cause of colic. There are some conditions that can precipitate the onset of colic.

1) A house full of stress can cause your baby to get upset, thereby causing stress and producing colic.

2) Overfeeding can also trigger or worsen colic. Most parents and caregivers are raised to believe that a baby cries because she is hungry, so they feed the baby more. Distinguishing your baby’s cry between that of hunger or colic may save both of you some frustration.

3) On the same note, colic is not caused by improper care. It is not your fault that your baby is crying inconsolably, contrary to what your parents, in-laws, or neighbors would say.

4) Studies have shown that most babies that are bottle fed or formula fed experience colic in higher incidences compared to breast-feeding babies. It is said that the nipples and sucking behavior of babies during bottle-feeding can cause them to ingest air, leading to colic.

5) GERD (gastro-esophageal reflux disease) is also associated with colic. But if your baby is vomiting, having diarrhea with bloody stool, your baby’s inconsolable crying is not related to colic.

HOW WILL I KNOW IF MY BABY HAS COLIC?

A baby is believed to have colic when she cries intensely and inconsolably on the same hour each day for more than three hours. This can occur up to 3 times in a week, and up to or more than 3 weeks in a month. While your baby cries, she would show these following behaviors:

Crying will start after feeding, starting and ending abruptly. This crying usually occurs during night time.

Clenched fist

Arched back

Legs pulled up to their bellies

Your baby will also show bloated or distended stomach, which anchors the theory that colic might be due to gas. If your baby has projectile vomiting, fever, diarrhea, lethargic, and has no appetite, consult your pediatrician immediately for these are not indicative of colic and warrants immediate medical attention.

HOW WILL I HELP MY BABY?

Since the cause is not fully established as to why your baby is having colic, a definite treatment is still also unknown. However, there are several ways for you to help your baby to help ease his distress.

If your baby has shown signs of being full like thrusting out her tongue to push the nipple out of her mouth, cease feeding her. Overfeeding only make your baby’s colic worse.

Never offer a pacifier to calm a crying baby with colic. Your baby will only ingest more air, causing further discomfort.

Always burp your baby after each feeding. This would help expel ingested air and prevent gas from accumulating in your baby’s stomach during each feeding.

Sooth your baby by gently walking around or dancing. The motion as well as your warmth will help your baby relax and sooth her colic.

A baby carrier or sling often works wonders for a baby with colic. Your baby will still be soothed while your arms and hands are free to rest.

Have your doctor recommend a safe probiotic for your baby. The probiotic will help your baby’s digestive system and can lessen the incidence of intensity of colic.

Having to deal with colic is never easy. When you feel all frazzled up and frustrated and feel that you may harm your baby, set your baby down in a crib and go to another room and relax a bit. Just make sure that your baby is safe and secure, and never leave her for more than 10 minutes. It would never help to slap your baby to stop it from crying, and shaking your baby can cause some severe neurological problems. Make sure you have adequate diet and sleep to help you cope with your baby’s condition. Sleep when your baby sleeps, for sleep deprivation will decrease your stress tolerance and that can also affect your baby. You may want to join a support group so you have someone who is familiar with what you’re going through when you talk about your frustrations in dealing with colic.

Shaken baby syndrome is a collection of signs and symptoms seen in a baby who has been shaken violently either by a parent or a caregiver. On average 1,000-1,500 babies are admitted in hospitals due to this condition. Statistics have shown that most of the people that harm babies and children as young as 5 years old are male: it can be a frustrated father, the boyfriend of the mother, or a male that is in his early 20’s. This can be due to lack of knowledge in baby care, or transferred anger or frustration felt by the person about anything other than the baby.

HOW DOES THIS HAPPEN?

Shaken baby syndrome can happen due to:

• Vigorous shaking
• Head trauma
• Throwing of a baby or child
• Careless and abrupt dropping on a bed, crib, sofa, or the floor.

WHAT HAPPENS TO THE BABY?

Mostly, the part that is most affected is the brain. Because of weak and underdeveloped muscles, vigorous shaking or sudden movement can cause the baby’s head to whiplash back and forth. This in turn will result to the brain hitting the skull. Constant trauma can cause contusion which will result in cerebral edema and even rupture of major nerves and blood vessels. The ruptures will cause cerebral hemorrhage, causing further brain impairment, and even death. Severe damage is most acquired when something abruptly stops the motion of the baby’s head such as a bed or a crib. Depending on the severity of trauma, a baby will manifest these signs and symptoms:

• Seizure
• Hearing impairment
• Blindness due to ocular hemorrhage or retinal detachment
• Irritability due to increased intracranial pressure.
• Vomiting
• Cerebral palsy
• Lethargy
• Apathy
• Difficulty staying awake
• Anisocoria (unequal size of pupils)
• Poor sucking or swallowing
• Difficulty of breathing

After a while, your baby will manifest these late signs and symptoms

• Developmental delays
• Impaired intellect
• Speech and learning difficulties
• Problems with memory and attention
• Severe mental retardation

CLINICAL MANIFESTATIONS

When a baby is brought to the hospital, several diagnostic procedures will reveal the following results:

Physical examination will show:

• Bruises around the head, neck, or chest

X-ray and/or CT-Scan will reveal:

• Fractured skull
• Swollen brain
• Blood clots or blood collections located at the brain’s surface
• Fractures in the arms and legs

Ophthalmoscopy will reveal

• Retinal hemorrhage
• Papiledema (swollen optic disc)
• Retinal detachment

IS THERE A WAY TO AVOID IT?

There are several ways to prevent shaken baby syndrome:

Never leave your baby in the care of an incompetent caregiver. Screen your baby sitter and look for references that indicate she is capable to caring for your baby without inflicting harm, deliberate or otherwise.

If you’re the one who’s taking care of your child, have plenty of rest and eat right. If sleep deprivation is a problem, sleep when your baby’s asleep. Invest in a good baby carrier so you can eat and do chores while still giving your baby warmth and comfort.

Buy a baby bouncer that is appropriate for your baby’s age to keep her entertained.

Utilize these five “S” formulated by Dr. Harvey Karp to help soothe your baby safely:

• Shush – turn on a vacuum cleaner, dryer, a TV that is not tuned, or play a CD that plays white noise.
• Siding/Stomach time – lay your baby on the left side to help her sleep comfortably. Give your baby supervised tummy time just in case your baby is having colic.
• Sucking – your baby may be hungry and just wish to be soothed with a pacifier
• Swaddle – your baby has been in a confined space for 9 months inside your womb. Swaddling will give him that same sense of security that she experienced during that period.
• Swing – rock your baby softly back and forth while in a rocking chair, an infant swing, or an infant seat that can be rocked.

Never hold the baby while in the middle of an argument, or while you’re feeling intense emotions.

Sometimes, the signs and symptoms of SDS are not noticeable until it’s too late. The damage done to a baby can be felt for a long time, and can require the need therapy. It is important that you put your baby down for 10 minutes on her back when you’re feeling overwhelmed. Prevention is better than cure, so do not bottle up your frustration in the belief that you can cope with the stress of taking care of a baby.

Vaccines are given to children to help protect them from major communicable and life-threatening diseases. Depending on the type vaccine, some may need series of doses, some just one or two. The types of vaccines to be given are as

TABLE BASED ON RECOMMENDED IMMUNIZATION SCHEDULE IN WWW.CDC.GOV

Hepatitis is ideally administered on birth if the HbsAg is either positive or unknown. The second dose is scheduled between the first two months, with the last dose given before the baby reaches before 24 weeks of age.

Rotavirus vaccine (RV) is first administered when the infant is as young as 6 weeks and maximum of 14 weeks. The next dose is scheduled at 2 months, and again at 4 months. If the dose is completed, a final dose on the 6th month is no longer recommended. It is not initiated when the baby is at 15 weeks or older.

DTaP is a combination of three types of vaccine: Diphtheria, tetanus toxoid, and acellular pertussis vaccine. It is first given at 2 months (6 weeks) and the next doses are given every 2 months. The vaccine can be completed before the baby reaches its 1st year, as long as the third dose was given 6 months before. A final dose or a booster is given when the child is between 4-6 years old.

Haemophilus influenze type B vaccine (Hib) is given as early as 6 weeks with succeeding doses given every 2 months. Depending on the type of Hib given, a dose on the 6th month may not be needed.

Pneumococcal vaccine (PVC) is given for children younger than 5 years old. Doses are spaced 2 months in between, with a fourth dose given as a booster.

Measles, mumps, and rubella vaccine (MMR) is given when the baby is 12-15 months old. The second dose may be given before the child reaches 4-6 years of age. Varicella is given in the same schedule. Hepatitis-A has 2 doses: the first dose is given 12 months, and the second dose is given at 18 months.

There are some controversies about scheduling vaccination. It is debated whether to defer vaccination on infants or not. Some vaccines, in fact, are linked to autism further strengthening some pediatrician’s belief on delaying the vaccination. It is important that parents play an active role in their baby’s vaccination by asking questions about the action and scheduling of vaccines and base their action on the response of the pediatrician. Each must fully understand the full capacity of a vaccine (its effects, and side-effects) before they agree on the vaccination.