harmful effects of second-hand smoke on children

If children live in a home where people do not smoke while the children are present, but do smoke a lot when they are not, how dangerous is the smoke that is in the carpet and furniture to their lungs?

Tobacco smoke that is released into the air by a cigarette, cigar, or pipe is known as second-hand smoke or Environmental Tobacco Smoke (ETS). It comes from the actual burning of the cigarette or the smoke that is exhaled (breathed out) by the smoker. This smoke contains several toxic parts that can lead to medical problems, including cancer.

Infants and children are most at risk from these toxins because their lungs are still developing and are considered more delicate. Children whose parents smoke have a higher chance of showing breathing problems. ETS has been associated with asthma, tonsillitis, bronchitis, pneumonia and other upper respiratory and lung infections. In addition, parents are very powerful role models for their kids. Children whose parents smoke are more likely to begin smoking themselves in adolescence.

How much harm does exposure to second-hand smoke cause? This depends on how much smoke is in the air and for how much time a person is exposed. The amount of ETS is affected by the size of the space, the number of people smoking in it and whether there is proper ventilation. After the smoking in an area has ended, it can take upwards of 3-4 hours to remove the smoke from just one cigarette and even then some of it may still linger.

There is a great amount of research to be done about the effects of second-hand smoke, including how harmful the leftover residue in places such as the carpet is. Currently the only known way to prevent these harmful effects of second-hand smoke is to never expose children. Not smoking at all is best for both the smokers and their children.
Henry H. Bernstein

recurrent miscarriages and having baby

I am 31 years old. In the last three years I've been pregnant three times, resulting in early miscarriages. My doctor says there is nothing wrong with me. I want to have a baby -- what can I do?
Recurrent miscarriages are really a tragedy for a couple, and I wish you good luck. And looking at statistics, I really think that you will have good luck. The chance of a miscarriage happening in any pregnancy is about 15%. The majority of miscarriages are caused by the sperm and egg failing to join together properly. If you study the genetic makeup of most fetuses that are miscarried, they are abnormal. Given all the tricky things that can happen when fertilization occurs, I am really surprised there aren't more miscarriages occurring.

The good news is that if one suffers a miscarriage, the odds are the same 15% of suffering a miscarriage in the second pregnancy. And even if a woman has gone through three miscarriages, the odds are 75% that she will carry a healthy pregnancy on the fourth attempt. (mary jane minkin, MD)

There are certain medical conditions that do increase the risk of recurrent miscarriages, and it sounds like you have had some of these investigated. Occasionally, women do not ovulate well enough -- a condition called inadequate luteal phase -- which can be monitored by doing a blood test to measure your progesterone level a few days before you are due to get a period. Some women have antibodies to a pregnancy, and these can be checked by blood tests for anticardiolipin antibody and lupus anticoagulant. Rarely, either you or your husband may have a genetic abnormality, which can be checked by looking at the chromosomes (called balanced translocation) from either parent. Finally, you could have some abnormality in your uterus, such as a polyp, fibroid or septum, which can be removed -- this would be discovered by doing an x-ray of your uterus called a hysterogram, or by looking inside your uterus with a hysteroscope.

If all these tests have been done and are normal, the odds are overwhelmingly in your favor. I would encourage you to go for it, Naureen. If these tests uncover a problem it can be dealt with, and I encourage you to, as the ads say, just do it. Good luck.

murmur of MVP in children

Question : As a child I was dx with MVP. When I last saw my cardiologist for near fainting spells, unexplained racing beats while resting, and dizziness after swimming laps, I was told that I had grown out of it. I recently had a physical for my new job with the state and the physician asked me if I knew I had a heart murmur. I told him that as a child I had been dx with MVP and had an echo at 12. My question is why did the state physician hear a murmur (graded it at +2) and my cardiologist did not? I do not know if I have regurgitation, I am now 23. Should I have a repeat echo?

The murmur of MVP can be heard sometimes and inaudible at other times. Since your cardiologist didn't hear it, I doubt if you have a significant leak. If you are healthy and can exercise as well as others your age, I would never get another echo. MVP is benign, unlikely ever to have and bad effect on your heart. On the other hand, if you are worried, why not get another echo. Echoes are absolutely harmless.

Passive Smoke Exposure Increases the Incidence of Sinusitis in Children

Persons who smoke cigarettes demonstrate dramatic increases in their levels of nicotine and nicotine metabolites; however, it is now clear that others who are exposed to the exhaled smoke (so-called "passive smokers") can also demonstrate nicotine levels that may affect their health and well-being. This health risk is particularly important in children. Research to date indicates that children exposed to passive cigarette smoke have elevated rates of otitis media, bronchiolitis, and diminished pulmonary function, as well as more frequent exacerbations of asthma.

A direct correlation has been observed between the extent of exposure to passive smoke and urine cotinine values. Cotinine is a metabolic by-product of nicotine that is readily measured in the urine. Numerous investigators have concluded that there is a correlation between the frequency of symptoms and signs of respiratory illness, such as nasal symptoms and even asthma, and levels of cotinine in the urine.

To further define what effect passive cigarette smoke may have on the health of children, Steven Stryk and colleagues from the St. Louis University Health Sciences Center asked parents to complete a detailed questionnaire about their smoking habits. They also collected urine samples from children in these households and periodically analyzed the cotinine/creatinine ratio (CCR), which serves as a highly reliable measure of exposure to nicotine. They are now following these children prospectively under double-blind conditions to determine their rates of sinusitis.

Previous studies have indicated that a CCR of 30 mg/mL or higher reflected significant exposure to nicotine through passive smoke inhalation. For example, Dr. Stryk noted that in smokers, one cigarette can increase the urine cotinine levels by about 135 ng/mL, and some smokers have urine cotinine levels of up to 1,000 ng/mL. In the twenty children (aged 3--18 years) studied to date, Stryk and his team have identified five children with urine cotinine levels higher than 30 ng/mL. One 5-year-old had a urine cotinine level of 298 ng/mL! Among these twenty children, there have been eight cases of sinusitis. Key to these findings is that all of the infections have occurred in the five highly exposed children.

In addition, the investigators found that whether or not their mother was a smoker was very highly correlated with the children's urine cotinine levels. Such findings suggest that when a mother smokes, the child may absorb clinically important levels of nicotine, and that these levels in many cases can affect the respiratory health of these children. source:AAAAI

Encasing Mattresses Improves Asthma in Children

According to some investigations, up to half of the cases of childhood asthma are exacerbated by the presence of allergens found in the excrement of the common house dust mite. Consequently, one way to combat asthma is to limit the exposure of children to these dust mite allergens. Removing carpeting and washing bedding are good ways to reduce the dust mite load in homes. New research also confirms that encasing the pillow and mattress of asthmatic children can have a dramatic benefit for their asthma status.

Dr. S Halken and colleagues evaluated the benefits of using a semipermeable mattress cover (Allergy Control brand) designed to prevent the passage of dust mite allergens. Sixty asthmatic children were given either the test covers or simple cotton covers, through which dust mite allergens could penetrate. The children were followed for 1 year. In the groups of children who used semipermeable covers, the concentrations of house dust mites decreased almost 10-fold, compared to only a 50% drop in the control group. Furthermore, the mean dose of inhaled corticosteroid decreased by about 50% in the semipermeable cover group (p = 0.003 compared to baseline) but only by about 25% in the control group . Morning and evening peak flows increased significantly in the semipermeable cover group, but only evening peak flow improved significantly in the control group.

These findings suggest that the use of a semipermeable mattress and pillow cover was associated with:

• a decrease in the concentration of house dust mites in the mattress

• a drop in the dose of inhaled steroid

• a decrease in allergen-specific bronchial hyperreactivity

• a decrease in nighttime asthma symptoms, and

• an increase in morning and evening peak flow measurements.

source:AAAAI

controlling allergy symptoms for children

Managing symptoms of allergy
Managing allergies properly should be an important part of your child's training and preparation for competition.

Classic allergy symptoms — such as a stuffy nose, watery eyes, sneezing and sinus pain — can affect your child's performance and most importantly, enjoyment of the activity. Allergy symptoms can make it difficult for your child to sleep at night.

Enlisting the help of your physician and getting an early start in controlling allergies can help prevent these problems. "As in sports, the best defense against allergies is a good offense," says Dr. Li. "Don't wait until the middle of the season to recognize there's a problem and to start treating it."

Before the season starts, ask your physician about your child's allergies and how they might affect his or her chosen activity. Tell your physician if your child is having trouble this year with any new symptoms. If your child isn't taking a medication, your physician might recommend one. If your child is taking a medication, ask your physician to evaluate both it and its dosage.

This might be especially important if your child is competing at the top levels of his or her sport. Some medications, such as oral decongestants, might be considered stimulants and athletes might be banned from using them.

As the beginning of the sports activity draws closer, Dr. Li recommends making sure that your child is taking the medication on schedule and isn't skipping doses. "Allergy medications work best when used early and regularly," he says.

You might also wish to add your child's coach to your allergy-management team. On days when allergies might be particularly troublesome for your child and others with allergies, the coach might be able to modify practice routines to prevent allergies from affecting athletes. Chances are, your child won't be the only one on the team with allergies.

Children, allergies and sports

If your child has hay fever, does that mean outdoor sports are off limits? Not at all, according to James Li, M.D., a specialist in allergy, asthma and immunology at Mayo Clinic in Rochester, Minn.

"Any athlete, from preschooler to pro, can have allergies and participate in sports," says Dr. Li. "Some professional athletes even compete when their allergies should be at their worst. With the right treatment, your child can compete in any sport he or she wants."

Considering options
Although it's true that allergies don't have to be an athletic roadblock, it's important to note that there might be better sports for your child to choose if he or she has severe allergies to outdoor pollens or molds.

If your child is just beginning to compete, consider taking a closer look at indoor sports or ones in which competitions take place during winter months. The reason? Your child likely will encounter fewer outdoor airborne allergens, such as pollen.

James Li, M.D."Good choices include swimming, basketball, ice hockey or indoor volleyball," says Dr. Li. On the other hand, indoor sports might aggravate allergies to indoor molds or dust mites.

levels of prolactin in blood

Question : I have high levels of prolactin in my blood. What does it mean?

Prolactin is a hormone from the pituitary gland that regulates the production of breast milk following childbirth. It also may suppress ovulation. The pituitary may produce too much prolactin as a result of use of certain drugs such as tranquilizers or oral contraceptives or — rarely — as a result of a pituitary tumor called a prolactinoma.

Prolactinomas occur in both women and men. In women, the prolactin may cause a milky discharge from the nipple, infertility or irregular or absent menstrual cycles. In men, it may lead to decreased interest in sex, impotence or infertility.

Elevated levels of prolactin in the blood (in the absence of medication known to cause it) warrants follow-up if the level remains elevated. Imaging of the pituitary with a CT or MRI scan may reveal a tumor. If a tumor is detected, treatment options include the medication bromocriptine or surgical removal of the tumor. The decision regarding the best option is based on specific findings. Usually, consultation with an endocrinologist is warranted.

Airplane travel with infants

Question: How old should a newborn/infant be before it is safe to take him on an airplane? What, if any, are the possible detrimental effects of taking an infant on board a plane?

There are both medical and safety aspects to your question.

Because newborn's bodies are rapidly adjusting after birth and because signs of illness in newborns may be subtle, neonatologists may advise against unnecessary air travel during the first 2 weeks of an infant's life.

The two most common related questions from parents are: "Does flying affect the child's ears?" and "Does flying increase the risk of sudden infant death syndrome (SIDS)?"

Flying affects infants' ears in the same way it affects adults' — changing cabin pressure causes changing middle ear pressure, which can distend the ear drum and result in pain and crying. Infants should nurse from the breast or take a bottle on the ascent and descent to equalize ear pressure. Infants with a recent ear infection might be more uncomfortable during the flight — check with your child's doctor before the trip if you have concerns. Your doctor can provide you with analgesic ear drops to use in case pain develops.

Little is known about the effects of changing altitude on young infants and whether the risk of SIDS is affected by air travel. At this time SIDS researchers believe that the risk of SIDS seems to be little altered by airplane travel.

According to the Federal Aviation Administration (FAA), "Flying is very safe, and mile for mile a child is safer flying unrestrained in an airplane than riding restrained in a motor vehicle."

Calculating Dietary Exposures of Children

To estimate potential exposure to pesticide residues, EPA uses food consumption data gathered as part of the U.S. Department of Agriculture's Nationwide Food Consumption Survey. The survey profiles the types and amounts of food consumed over several days for all Americans, as well as subgroups.

All foods are analyzed by their separate ingredients using EPA standard "recipe files" for 300 different foods. For example, the amount of wheat flour, tomato, cheese, oregano, and other ingredients are estimated for a serving of pizza. All foods in a person's daily diet are analyzed, and the amounts of similar food components are added (e.g., total amount of wheat flour consumed from various foods in a day). These data, in turn, are used along with information on pesticide residues on individual foods to estimate overall dietary exposure to a pesticide.

EPA also has developed a special data base known as the Dietary Risk Evaluation System (DRES). This system allows the agency to refine its exposure estimates for pesticides in the diets of infants, children and other potentially sensitive subgroups. The DRES system provides information on food consumption for more than 300 food commodities for 22 different subpopulations.

According to William Farland, Ph.D., director of EPA's Office of Health and Environment Assessment, "If the DRES analysis indicates that exposure to a subgroup is so high that adverse effects may occur, then EPA will not approve a tolerance even if the estimated risks to the overall population are acceptable."

One case in which EPA did not approve a tolerance because of specific dietary concerns for infants and children involved the pesticide pydrin in 1985. New uses of the chemical on alfalfa and sorghum were requested to be allowed. However, EPA determined that the potential risks to children from secondary residues in milk from cows eating such grains were unacceptable, and the agency denied the request.

When it comes to food additives, FDA requires the manufacturer or sponsor of a food additive petition to provide an estimate of the anticipated consumption of the substance, based on the food categories in which its use is proposed. Such data include frequency of consumption and amounts consumed by all age groups, based on a nationally representative sample of Americans.

hyperactivity in children

Its symptoms are often described as nervousness, aggressiveness, impulsive behavior, short attention span, "ants in the pants," and even "bouncing off the wall." And next to child care, it seems to be the most popular topic of discussion whenever parents of toddlers and elementary school children get together. In reality, hyperactivity or attention deficit-hyperactivity disorder (ADHD) affects a small percentage of children in the United States. Medical authorities estimate about 5 million children are affected to varying degrees. It begins by the age of seven and is 10 times more common in boys than girls. Because the cause and cure for this condition continue to be elusive, it remains a frustration to parents, physicians, educators, and school counselors, as well as its young victims alike.

Childhood hyperactivity is not a new condition. Accounts of the disorder have been documented in the medical literature as far back as the 1880s. Today, scientists believe that ADHD is probably caused by a combination of certain genetic, environmental, neurological and biochemical factors. Because there is no known cure for this disorder, treatment usually involves multiple approaches, often a combination of medication, psychological intervention and modification of the child's environment.

Dietary modification has sometimes been recommended in treating hyperactivity. Although this approach has received much publicity, scientific evidence does not support a connection between diet and hyperactivity.
source: Food Insight

insulin-dependent diabetes and birth defects

question: Can women with insulin-dependent diabetes reduce their risk of having children with birth defects?

Women who have insulin-dependent diabetes at the time they become pregnant have a two-to-three times greater risk of having malformed babies than other women. These malformations can affect the central nervous system, heart, kidneys and other organs. Unfortunately, the biochemical mechanisms or causes of such malformations are not yet known. But practically speaking, the risk of malformations can be reduced considerably with good metabolic control prior to the time the embryo's organs start developing. So if a woman with insulin-dependent diabetes has her blood sugar well-controlled before she gets pregnant, her risk of delivering a malformed baby as well as miscarriage is much, much lower.

source :An Interview with James L. Mills, M.D.,ificinfo.health.org

incidence of birth defects in USA

question: What is the incidence of birth defects today in the United States?

The risk for major malformations among the general population today is around two percent. Certain segments of the population, however, such as women with insulin-dependent diabetes and those who have given birth previously to a child with neural tube defects, have an increased risk of delivering malformed babies compared to the general population. In both of these latter instances, metabolic or nutritional factors are certainly important.
source :An Interview with James L. Mills, M.D.,ificinfo.health.org

Food Protection for Children

Children Are Not Small Adults

Children cannot be viewed simply as miniature adults, said pediatricians, toxicologists, and regulators gathered last fall at a risk assessment symposium on similarities and differences between children and adults. Sponsored by the Environmental Protection Agency and the International Life Sciences Institute, the symposium evaluated biological, social and environmental factors related to children that can affect their risk from foods, pesticide residues or other substances.

Most notably, children's dietary patterns differ from adults in both quantity and types of foods consumed. In relation to body weight, children eat more food than adults to meet their demands for rapid growth. This is particularly true among preschoolers.

Also, children's consumption of certain types of foods such as fruits and fruit juices can be quite different from adults. In addition to these basic dietary differences, variables such as nutritional status, socioeconomic level, culture and geographic location can profoundly affect a child's health risk from certain substances.

While not exposed to the same occupational hazards as adults, children's home, school and play surroundings can influence their health risk. J. Michael Davis, Ph.D., a health scientist with the EPA Office of Health and Environmental Assessment, has noted that children are generally exposed to much higher levels of lead through airborne sources, household dust and soil, lead paint, and pipes, in addition to diet. Thumbsucking and other typical hand-to-mouth behaviors may account for as much as 80 percent of all children's lead-related exposures.

Several biological factors in children can make them either more or less sensitive than adults to various substances. Children have higher rates of breathing and blood flow, and many of their organ cells multiply at a faster rate through normal growth. Also, the rate at which certain drugs or chemicals pass through cell membranes in children varies from adults, influencing potential toxicity.

In addition, children's metabolism of certain chemicals may be more or less efficient than adults. Young children are known to have a greater tolerance than adults to acetaminophen, the most widely used over-the- counter drug for pain and fever in the United States. Some scientists believe this phenomenon may be due to children's greater capacity to safely eliminate the drug by non-toxic metabolic pathways.

The immature immune systems of infants and children can also place them at greater risk from infection, including microbiological contamination of foods. Health officials are stepping up public education efforts to reduce incidence of foodborne illness in children and other groups such as the elderly that may have vulnerable immune systems.

Children and Food Safety Risk

Whether selecting a family car, deciding where to live or just choosing what to watch on TV, parents everywhere tend to share the same credo- nothing's too good for my kids.

Ensuring the safety and wholesomeness of foods for infants and children is no exception.

But public confidence in food safety for the nation's 63 million youngsters is unsteady. As one recent example, the Alar controversy panicked many parents into pouring out apple juice and school officials into banning the sale of apples from school-lunch programs.

And according to a recent poll by the Center for Produce Quality, 72 percent of Americans believe pesticide regulations do not sufficiently account for children's health risks.

In the wake of such concerns, child health advocates, environmentalists, the food industry and others are working with federal authorities to bring the best scientific evaluation possible to pesticides and other food-related risks to children.

non-drug treatments of migraine for children

Drugs usually provide significant relief from migraines. In addition, you and your child have a safe arsenal of non-drug strategies to draw on as well. Among them are:

Rest — Allow your child to lie down when a headache starts. Isolation in a quiet, dark room may help even more.

Biofeedback — This relaxation technique uses equipment that displays moment-to-moment changes in skin temperature. With this equipment, children can learn to consciously control the temperature of their fingertips (warmer fingers are one sign of relaxation). "This is the behavioral treatment I recommend most commonly," Dr. Buchhalter says. "It has been demonstrated in reasonable scientific studies to be effective. Biofeedback helps kids who are sensitive to medication, and it provides the child with relaxation skills to apply to other potential stressors."

Dietary change — Some children experience relief of migraine when they avoid certain foods.

Headache diaries — Knowing when and where headaches occur can help your child discover and avoid migraine triggers. Help your child write down this information on a daily calendar.

Schedule regular follow-up appointments to assess and adjust your child's treatment plan. Seeing the same physician each time can help your child develop comfort with the care and confidence in the plan. Those attitudes can promote the long-term goal — a life that's as free as possible from the limiting effects of migraine.

migraine treatments for children

Medication for headaches offers three lines of defense.
First-line medication includes over-the-counter pain relievers — Acetaminophen (Tylenol, Panadol), ibuprofen (Advil, Motrin, Nuprin), and naproxen sodium (Aleve) are most common. Because of potential side effects, do not give aspirin or naproxen to a child unless you consult with a physician.
A second group of drugs aims to relieve more severe pain, especially when a headache has already started — Examples are ergotamine and sumatriptan, which are available only by prescription. These are sometimes combined with medications to relieve nausea and vomiting.
The third group includes drugs designed to prevent headaches from starting — Included here are tricyclic antidepressants, beta-blockers, calcium channel blockers and serotonin antagonists. These medications also require a prescription.


Carefully follow the instructions for taking any medication, and be sure to ask your doctor about the potential benefits and risks. In high doses, even over-the-counter pain relievers can be dangerous. Don't give your child pain relievers along with cold medication, as some cold medications already include pain relievers.

To make your child's treatment more effective, ask for a medication schedule that involves the fewest possible doses per day. See if your child can avoid doses during school hours. Also, monitor your child's medication. One simple strategy is to give children medication and stay to watch them swallow it.

treatment for migraine for children

Knowing when to seek treatment for a child's headache can be difficult. Some headaches in children seem clearly linked to a specific event — perhaps an upcoming test or a fight on the playground. In such cases, headaches may soon pass.

In other cases, headaches are so frequent or so painful that they routinely curtail a child's activities. Such headaches can include migraines, and they call for a physician's help.

Dr. Buchhalter recommends that children be seen by their health care provider when headaches lead to significant pain or cause them to miss school, play or other activities.

Chronic headaches in children can arise from many causes besides migraine — tumors, infections, persistent stress, and more. This makes it doubly important to seek medical evaluation and treatment.

Migraine can occur without headache in children

Definitions of migraine vary. In 1988, the International Headache Society offered a set of criteria that has been widely quoted since. According to this definition, a person with migraines:

Has had at least five headaches in a lifetime.

Experiences at least two of the following symptoms: one-sided, throbbing pain that's moderate to severe; pain that worsens with activity; sensitivity to light or sound; nausea or vomiting.

Has symptoms lasting from 2 to 72 hours per occurrence.

Sometimes the symptoms of a migraine occur even without headache, making diagnosis all the more challenging. "Older kids tend to have more abdominal symptoms — so much so that they can have vomiting, stomach discomfort and dizziness in the absence of a headache," says Dr. Buchhalter. "These symptoms are more common in kids than adults."

Researchers are still not sure what causes migraines. However, there's strong evidence that the tendency to have migraines is inherited. One study found that 90 percent of children with migraines had a family history of such headaches.

migraine in children

Believing that migraines are strictly an "adult" problem, some parents don't know about treatments that could relieve their children of recurring and sometimes disabling pain.migraine in children article

Studies indicate that up to 93 percent of children will complain of head pain. A smaller but significant number of children — between 2.5 percent and 22 percent — will experience the intense pain of migraines. What's more, these headaches can start early. Researchers report evidence of migraine in children as young as 2 years old.migraine in children article

In children that young, a lack of verbal ability complicates the diagnosis. "A child between 2 and 4 years of age may manifest the headache just by crying, being irritable, turning pale, vomiting or head-banging," says Jeffrey R. Buchhalter, M.D., a pediatric neurologist at Mayo Clinic, Rochester, Minn. "A lot of folks make the mistake of believing that such children can't get migraines. They clearly can."

Cat scratch fever in children

question My daughter has been diagnosed with cat scratch fever and no one really knows much about it. Can you tell me what you know about this infection? Should I get rid of the cat? Can my daughter get it again?

Cat scratch fever, also known as cat scratch disease, is an uncommon infection that occurs mostly in children. It follows a scratch or bite from a cat, usually a kitten, that shows no sign of illness. There is good evidence that the disease is caused by a bacterial agent or agents. In humans, there is usually evidence of infection at the site of injury and swelling of lymph nodes. Fever is present in less than half the cases.

Bacteria in an excised lymph node is strong evidence of the disease, as is a positive skin test to the organisms. However the skin test is not licensed and is not readily available.

Most people recover without treatment. The issue of lasting immunity is not clear but recurrences are rare. In instances where several persons have been scratched by an infected cat, less than 10 percent became ill. It should not be necessary to get rid of the cat.

mother breastfeeding - Does My Baby Need to Be on a Schedule?

Babies are as different from each other as are adults. Some babies, like some adults, naturally prefer a regular schedule with predictable times of feeding, sleeping, and activity. Other babies and adults seem to thrive on less regular schedules. As you get to know your baby and learn to recognize his/her cues, you will probably see some consistent patterns of sleeping and feeding, but they may vary from day to day. If well-meaning friends or relatives pressure you to "put that baby on a schedule," think about whether the schedule truly meets your baby's needs or if it's meant to please other adults. Learn to "watch your baby, not the clock," and know that responding to your baby is more important than trying to regulate him or her, mother breastfeeding.

Newborns need to eat very frequently, since the have tiny stomachs and since breastmilk is digested very rapidly. In the first few weeks, babies need to nurse ten to twelve times per day, and their feedings will gradually space out as they grow older. Any schedule that prevents newborns from breastfeeding at least every 2-3 hours (or less during growth spurts!) could potentially cause the baby to gain weight poorly, mother breastfeeding.

Healthy full term infants need to nurse every 2-3 hours during a 24 hour period. This equates to 8-12 feedings per 24 hours. A newborn should not go longer than 3 hours between feedings for two reasons 1) so that they get adequately nourished and hydrated and 2) to ensure that your breasts are stimulated enough to establish a full milk supply, mother breastfeeding.

mother breastfeeding - How can I tell if my baby is getting enough milk

Typically during the first few days, while the baby is only receiving colostrum, the newborn will wet only one or two diapers per day. Once mother's milk comes in, usually on the third or fourth day, the baby should begin to have 6-8 wet cloth diapers (5-6 wet disposable diapers) per day. Most young babies will have at least two to five bowel movements every 24 hours for the first several months. Remember output = input. Also, check to make sure that baby seems alert and content. Babies that sleep too much or are generally lethargic may need to be assessed by a pediatrician to make sure that he/she is not becoming dehydrated from a lack of time at the breast, mother breastfeeding.

If your baby has 6-8 cloth or 5-6 soaking wet disposable diapers, and 2-5 bowel movements in each 24 hour period, you can be sure that he/she is getting enough milk. Remember output = input. Also, check to make sure that baby seems alert and content. Babies that sleep too much or are generally lethargic may need to be assessed by a pediatrician to make sure that he/she is not becoming dehydrated from a lack of time at the breast, mother breastfeeding.

Any brand-new mom is going to be anxious about her baby getting enough to eat, and because breasts are neither see-through or marked off in ounces like a baby bottle, we have to look for other signs to make sure baby is getting enough milk.

Watch for these to tell if baby is getting enough milk - weight gain and wet and messy diapers.

From birth to four months, a breastfed baby will typically gain 4 to 8 ounces a week. From 4-6 months, baby will gain 3-5 ounces per week. From 6-12 months, weight gain slows to 1 1/2 - 3 ounces a week, mother breastfeeding.

Watch for 6-8 cloth or 5-6 wet disposable diapers and two or more bowel movements a day. An older baby, 2 months or more, may cut down on bowel movements and may even go several days between BMs. Rest assured that as long as baby is gaining weight and having wet diapers, baby is getting enough milk.

Some breastfed babies, after the newborn period has passed, have very infrequent bowel movements. This is no cause for alarm; it just means that the baby's system is so efficient at processing breast milk that no solid waste products are being produced. Breastfed babies cannot become constipated--when these babies do have a bowel movement, it will be loose, just like those of typical breastfed babies. It is still a good idea to mention very infrequent bowel movements to your health care professional, in case there is an underlying problem, mother breastfeeding.

book review - babycare for beginners

Williams, Frances. Babycare for Beginners.

This book provides step-by-step directions on the basics of baby care, including handling, diapering, cleaning, dressing, bathing, and playing together. The simple, brief text (in large bold print) is supplemented by many photos of parents and babies, making each task very clear and do-able. This book has a unique format: it can be placed upright and open on a surface (such as a changing table). Thus, parents can refer to the text but keep their hands free to attend to the baby. No doubt, this will be a useful resource for new parents.

book review - infant development (first year)

Eisenberg, Arlene; Murkoff, Heidi; & Hathaway, Sandra. (1996) What to Expect: The First Year. NY: Workman

This practical guide presents a month-by-month description of development during the first year. Each chapter includes an overview of developmental milestones for the month, what to expect at the monthly check up, information about feeding, parents' questions, and what's important to know. Other sections focus on special concerns (e.g., illnesses, low birth weight, becoming a father) and ready references (e.g., food recipes, remedies). Written in an easy-to-read style, the book is informative and reassuring. The major developmental milestones are described in terms of what an infant "should" be able to do; parents may find these normative standards too narrow.

book review - infant development

This book is the first in the Gesell Institute series focusing on different age periods. General characteristics of 12 to 24 months olds are described, with attention given to the difficult 18 month-old. Development is described as alternating periods of equilibrium and disequilibrium, when abilities consolidate and then break up as new growth occurs. Routines, techniques of discipline, individuality, mental life are covered in separate chapters. Letters from parents are included. This small book presents a vivid portrait of the one-year old and will reassure parents that their child's puzzling or difficult behavior is quite normal.

Practical Parenting Tips

Practical Parenting Tips : Over 1,500 hints are given for parents of newborns to five-years olds. From mealtime to birthday parties, the author includes chapters on hygiene and health (bathing, teeth brushing), challenges (tantrums, toilet training), family on the go (shopping, traveling), and children's play (buying and making toys). Advice from parents is interspersed throughout. Written in short, concise list form, ideas on any topic are easy to locate. All parents will find creative ways to save time and money in this book.
book:Lansky, Vicki Practical Parenting Tips (1992) Deephaven, MN: Meadowbrook Press.

rasing adopted children

Rasing adopted childre: Written by a mother of two adopted children, this book addresses important issues: adjustment of the family, bonding and attachment, talking with children about adoption, and other aspects of parenting. The views of experts, parents, and adopted children are included. This book offers parents valuable information and insight into how to deal honestly and openly with themselves and meet the psychological needs of their child.

Caring for Your Baby and Young Child

Caring for Your Baby and Young Child: Birth to Age 5
Developed by the American Academy of Pediatrics and Feeling Fine Programs, this guide addresses parenting and medical concerns. A month-by-month guide to the first year and a yearly guide for the 2—5 year period provide developmental milestones and practical advice on effective discipline, optimal nurturing and child-rearing concerns. Lists of age-appropriate toys and activities are included. The guide also explains how to recognize and solve common childhood health problems and how to deal with emergency medical situations. The information presented here is comprehensive and interesting; the material is well-organized and easy to access; the illustrations portray diverse families.

Taking Care of Your Child - book review

Taking Care of Your Child. A Parent's Guide to Complete Medical Care
The physician-authors provide information on pregnancy and the care of newborns and describe growth patterns and behavior/personality development in infants and toddlers (and up through adolescence). Most of the book addresses child health, including preventative measures, immunizations and home medical supplies. More than 100 common complaints -- injuries and allergies, childhood diseases, and everyday worries -- are discussed in understandable, clear terms. Easy-to-follow decision charts indicate exactly when to call a doctor.

The First-Aid Handbook for Childhood Emergencies - book review

Preventative measures at home and out-of-doors are discussed with sections focusing on infant equipment and toy safety. Common childhood illnesses and disorders are covered along with recommended treatment. Most of the book describes emergency first-aid procedures, step-by-step with large, clear illustrations. A quick-access emergency index is provided. This book is an indispensable, easy-to-use reference for all parents.

baby learning - Fifteen to Thirty-Six Months

What is your baby learning?

* Your child is learning to recognize himself or herself as a separate physical being.

* Prior to 18 months, young children do not seem to know that what they are seeing in the mirror is their own reflection. In one experiment, a researcher had mothers put a spot of rouge on their child s nose without the child knowing it. At 18 months, the child pointed to the mirror. By two years, the child touched his own nose as if he knew that the face in the mirror was his own face.

* Toddlers are able to store a memory and hours, days, even weeks later, that memory will be retrieved and guide their behavior. They watch how you pet a cat, and another time, when you re not around, they do the same thing. This capacity for "deferred imitation" explains in part how they learn so much so quickly!

* Toddlers also play symbolically, letting one thing stand for another. They pretend they are a tiny baby and crawl into a doll s bed; they pretend to be "Daddy" and give a doll a bath. They push a block on the floor, pretending that it s a dump truck. This rich, imaginative pretend play shows their minds at work and often reveals feelings that can t be expressed in words.

* The toddler years are traditionally known as the time when children declare that they are their "own person." They are eager to explore and experiment. They re leaving behind the dependency of infancy and feeling the independence of toddlerhood. What this means is that they want to take control and be separate from you. In terms of their emotional development, this is a healthy and inevitable step.

What are you, the parent, learning?

* Exercising authority. As a parent of a toddler, you may be wondering "how do I discipline?" First of all, think about discipline as teaching it s not equated with punishment. Your job (and it is a job with an assertive toddler) is to teach your child how to develop self-control, but you must also realize that this takes time. When your child is young, you will have to set limits, repeat them, and expect they won t work all the time. You ll also want to model the kind of behavior you do want (remember that your toddler will imitate you long after you ve acted in certain ways). Keep in mind, that children who have solid relationships with their parents care about doing what their parents want. So the nurturing, responsive relationship you establish with your baby is the foundation for socializing your toddler.

* Young children are adept at finding their parents hot buttons. This is a time to learn to deal with your own anger in a way that doesn t pass it on to your child.

Baby development - Fifteen to Thirty-Six Months

Your child is learning how to communicate feelings and thoughts with words. As your child uses language and moves about on his own, he seems like a substantively different person again. Between 15-36 months, he is a full-fledged toddler. He asserts his independence and his separateness from you. More and more, he s becoming his own person.

baby learning - Seven to Fifteen Months

What is your baby learning?

* Your baby is continuing to learn to recognize and to share his thoughts and feelings. By the end of this period, babies use more and more language to communicate. They want to try out their verbal skills and are busy naming and describing: "more" (when they want you to continue playing with them), "ba-ba" (when they want their bottle).
* Your baby is also learning to read the emotions of others. She will look to you for cues about how to respond in a situationÑespecially one that's unfamiliar (a new child care provider) or unusual (a balloon pops). It's the way that infants figure out how to respond to the world.
* During this stage, your baby will make giant leaps in language development. She or he will progress from making repeated sounds to saying simple words, like "baba" for bottle. Maybe even putting two words together: "Mommy sock" (your sock), or "nice doggie."
* Babies of this age are better able to remember the past. You'll see signs of your child's improved memory in her or his behavior: when you turn on the water in the bathtub, he'll get excited, knowing that his favorite playtime is about to begin.
* Your baby is learning how to separate and connect back to you and other important caregivers. As you go out the door, leaving your nine-month-old behind with a caregiver, he may begin to protest, trying to follow you or calling out for you. But with repeated separations, your child learns that you'll return and over time, separation anxiety diminishes

What are you, the parent, learning?

* Holding on and letting go. As your toddler begins to venture out in the world, you'll act as a secure base to which she'll return when she needs refueling. You'll work on finding the balance between holding on--protecting him, making his explorations safe--and letting go--encouraging him to explore and take risks.

Baby development - Seven to Fifteen Months

Your child makes the transition into toddlerhood and can now get around more independently. He crawls, then walks, and can move out into the world, away from you, in order to explore. Your child is learning about how to separate and reconnect and how to engage in two-way communication. Children will show a preference for familiar people and will look to their parents for encouragement and reassurance.

baby learning - Two to Seven Months

* The mutual exchanges that go on between babies and their caregivers help the babies learn to soothe or control themselves. There are circuits in the brain which are activated by this dance. These circuits are linked to those that regulate the body's physiology (like heartbeat) and the child's emotional state. Repeated, attuned experiences (so called because you are "tuning in" or sharing feelings with your child) allow children to develop brain circuits which can balance emotional and physical responses as they grow. The part of the brain that is responsible for regulating emotions is growing rapidly now. Remember that before about four months of age, babies are only able to focus their vision at about two feet in front of their eyes. Coincidentally, this is the same distance as between a baby's and mother's face during breastfeeding. During this early period of face-to-face interactions, it's helpful to be close enough so your baby can get a good look at your expressions.
* Your baby is learning the capacity for joy and pleasure. In fact, the parts of the brain responsible for experiencing and expressing emotion develop from the way caregivers interact with your infant. A nurturing environment is necessary for baby learning.

What are you, the parent, learning?

* Just as your baby is becoming attached to you, you are bonding with your baby.
* Facing feelings of attachment. You may wonder, "Can I take care of my child? Is my baby's behavior normal? Is what I'm doing the right thing?" A period of wonder and worry, of highs and lows, is a normal part of getting to know your new baby.
* Parents are often surprised at their reactions to their baby. They are more or less patient, more or less calm, feel more or less competent than anticipated. Just as the baby is beginning to develop a sense of self, so are parents. Post partum blues are experienced by many mothers in the first few months after birth. Changes in hormonal levels, lack of sleep, changes in lifestyle and perhaps the loss of an expectation--"that I was going to be a perfect parent, that parenthood was going to make me completely happy," can trigger depression. If you're feeling sad, you may want to ask yourself if you have an expectation that is unrealistic. If depression becomes severe and persistent, you may want to ask for help from your physician.

Baby development - Two to Seven Months

Two months is almost as clear a boundary in development as birth itself. More and more, your baby is establishing direct eye-to-eye contact, smiling and cooing. This period of intense sociability is often initiated by your baby when he or she is in an active, alert state. During this period, your interactions with your baby are like a "dance." When you engage in this dance, you are being nurturing and responsive to your baby--you are laying down the foundation of an "attachment" relationship.

caregiver stress

You are learning about yourself as a caregiver.
The following vignette, adapted from Heart Start: The Emotional Foundations of School Readiness by ZERO TO THREE, illustrates how the care infants receive affects their learning about themselves and others:

Three a.m.
A young mother hears a cry from her 5-week old baby in the nearby crib. It is 3 a.m. The mother’s initial dismay turns to anticipation of the feeding that will now begin.
The baby senses the lights turned on, feels the touches and the cradling of her mother’s body and, though hungry, begins immediately to calm from the cues that tell her that her discomfort is about to end. The baby nurses for half-an-hour, pausing between bursts of sucking and woozily gazing up into her mother’s eyes; the mother feels pleasure and recognition. During the pauses the mother speaks softly to her new daughter. The baby smiles, watching her mother’s shifting expressions. "Hi, Emma—sweet Emma—you are very pretty. You were hungry! Do you want more? Do you need a burp? I am happy to see you." The baby slowly begins to drift off. Her mother puts her in the crib, kisses her, covers her, and says, "Sweet dreams."
What is happening is utterly ordinary; a mother is feeding her baby. But what is happening to the baby is extraordinary. Because she is being fed, she is learning about gentleness and about cries being answered. She is beginning to sense the subtle rhythms of exchange with her mother. It is the beginning of learning that she is worth responding to, that she is important, and that someone can be relied upon.

"Shut that baby up!"
A young mother hears a cry from her 5-week old baby in the crib nearby. It is 3 a.m. The mother tenses. She has just fallen asleep after a fight with the baby’s father. The baby’s cries rapidly intensify. "Oh, be quiet," says the mother exhaustedly. "I can’t take one more thing." The baby cries more and more loudly.
"Shut that baby up!" comes a neighbor’s shout from beyond the thin wall—"shut that damn baby up!" The mother slams her fist against the wall and shouts, "Shut up yourself!" She rolls out of bed and approaches the crib. "I’m coming— I’m coming. Damn it—shut up." She lifts the baby up and she quiets a bit. "Already think you can cry and just get what you want, don’t you? That won’t last long, I can tell you. Come on let’s get it over with." As the baby begins to nurse, the mother stares fixedly ahead, going over the recent angry fight. The mother grows more agitated as she recalls the details. The baby responds to her mother’s tension by squirming restlessly. Finally, the baby stiffens, arches, draws back from her mother’s nipple and yelps. "You don’t want to eat? Fine, don’t eat," says the mother and abruptly puts the still hungry baby back in the crib. The baby cries and the mother feels a surge of anger. "Shut up—just shut up." The mother leaves the bedroom, shuts the door and in the kitchen turns up the radio loudly enough so that she cannot hear the baby cry. The baby cries until she falls into an exhausted sleep.
This baby is also learning. She is learning that to be handled and held can be uncomfortable and distressing; that desperate crying may lead only to sharp and angry voices; that her needs and wants are not important and that there is no one to count on.
Of course, some babies cry ceaselessly even when they are held and gently fed. But studies show that babies who are cared for lovingly and responsively, eventually cry less and sleep more at night. When either of the two above experiences are repeated again and again, the effect on the baby’s sense of self and of the world are profound.

infant learning

What is your infant learning?
Newborns regularly occupy a state of alert inactivity—they are quiet and alert and will focus on your face or voice.

In the first few weeks of life, babies recognize and prefer familiar faces. If a parent and a stranger talk to a newborn, the baby will turn his or her face toward the parent, not the stranger.
Infants know the smell of their mother’s milk. One researcher placed three-day-old infants on their backs and placed breast pads from their mothers and from other nursing women on either side of their heads. The infants turned toward the smell of their own mothers. Smell is one of the first connections newborns make with their mothers. Within seconds of the time that a newborn smells his or her mother, indelible networks of attachment and recognition are formed in the brain.

Two-day-old infants may imitate an adult who smiles, frowns or shows surprise. Babies have an innate capacity to imitate and do what people around them are doing.

Babies as young as six weeks have learned to respond differently to their mothers and fathers. When the mother approaches, babies tend to relax their bodies, their heart and respiration rate soften. When the father approaches, the babies’ heart and respiration rate go up, their eyes open wide, as if to say: "It’s party time...this is Dad!" In general, mothers’ interactions are calming, while fathers’ are more playful and the babies’ reactions reflect these differences.

Through the experience of being cared for, your baby is beginning to learn how to regulate his emotional state and calm down. Areas of the brain that regulate bodily functions like heart rate, temperature and sleep are developing in these early months. When you hold your crying baby and calm him by talking or rocking, your baby is learning that intense distress can decrease. At first your baby relies on you, and then develops ways to calm himself over time.

Birth to Two Months

During this time, your newborn is dependent on you for feeding, warmth, and comfort and is also actively seeking stimulation through looking, hearing, and being touched. Your baby is beginning to form a rudimentary sense of "who I am."

Child’s Development, from Birth through age Three.

Studies have shown that many parents are aware of the milestones in children’s physical development (sitting, crawling, walking). These signs of growth are obvious and visible. However, many parents say they know less about the emotional, social, and intellectual aspects of development. They wonder "What is my baby thinking about?" "Does she know who I am?" "What makes him feel happy or sad?" The following description of your child’s early development addresses these and other questions.
As parents, it’s important to keep in mind that all aspects of development are inter-related. Growth in physical development goes hand in hand with growth in emotional, social, and intellectual functioning. For example, when your child begins to walk, he’s also going to start developing new feelings about himself ("I’m more on my own now").
Distinct Phases of Children’s Development from Birth to Three
You can think of a young child’s development in four different phases, each of which corresponds to the child’s emerging sense of self as a separate person.

The Father’s Role in Pregnancy

There are many ways for fathers-to-be to become involved prior to delivery. Attend prenatal checkups with Mom, observe prenatal tests such as amniocentesis and ultrasound, and help plan for the baby’s arrival. As term approaches, fathers should attend classes to learn how to help with labor and delivery, as well as how to help care for the baby after birth by changing diapers, feeding, and so on.

prenatal care

If possible, consult your physician when you are planning on becoming pregnant. Typically, the first official prenatal care visit with a doctor isn’t until a woman is a third or more through her pregnancy and prevention opportunities may then have been missed.
Women need to be aware that their dietary requirements during pregnancy are different than at other times in their lives. In addition to eating a balanced diet, pregnant women need an increased intake of calcium (particularly during the later months), iron (supplements are recommended), and some vitamins and minerals. In particular, folic acid (typically found in B complex vitamin supplements), taken before conception and during the first trimester of pregnancy is recommended to reduce the risk of birth defects.

By following the guidelines listed below and maintaining a low-stress lifestyle while pregnant, you can help ensure your fetus’s healthy development.
Practice good nutrition.
Maintain a regular exercise program.
Have regular check-ups.
Avoid tobacco smoking at all costs during pregnancy. Smoking is associated with an increased incidence of premature birth, as well as low birth weight.
Avoid substance use (including alcohol) at all costs. Effects from substance use vary, ranging from birth defects to neonatal addiction (the baby is actually born addicted to the drug). The developing structure and function of the brain is directly affected by these toxins.
Avoid over-the-counter and prescription medications, unless recommended by a doctor. The safety profiles of most drugs are well established, and safe alternatives are often available.
Avoid ionizing radiation, primarily X-rays, if at all possible. (Although judicious use of X-rays to preserve the mother’s or baby’s health may be warranted.)

Identify and treat mental health problems, especially depression. Excessive mental anxiety and stress can affect the environment of the growing fetus. Your emotional difficulties during pregnancy and afterwards may impair your ability to communicate with and take care of your child.

Taking care of yourself while pregnant is critical to your child’s life-long development.

brain development baby

The beginning of brain development starts soon after conception and continues throughout the prenatal period. The main thing that’s happening is the production of brain cells, called "neurons." During this time, the brain produces many more neurons than it needs, and by birth, excess cells have been shed. At birth, a baby’s brain has approximately 100 billion neurons--just about enough to last a lifetime. During the pre-natal period, neurons must find their way to exactly the right position on the cortex wall (where thinking and remembering occur); if they go astray, this can cause serious developmental problems (tobacco, alcohol and substance use, as well as radiation, are the most common causes of such problems).

learning kids...

Even though I have told my very intelligent 18-month-old daughter 100 times not to climb on the coffee table, she continues to do it, even though she understands when I say “NO!” I am very frustrated--is she being bad or am I expecting too much?

Children can understand "no" from a very early age...often by nine months. They figure it out by the tone of your voice and your facial expressions which essentially tell them, “I am not happy at all about what you are doing.” In general, childrens’ ability to understand what they hear (receptive communication) develops much sooner than their own ability to communicate by talking (expressive communication). However, while babies will often stop dead in their tracks when you tell them “NO!”, they do not yet have the capacity to exercise the self-control necessary to stop themselves from going for a desired object or engaging in an activity (such as climbing tables). Everything is so new and fun to explore! It is actually at your daughter’s age--around 18 months-- that toddlers begin to develop this capacity for self-control; but it is an ongoing process that develops over many months and varies with each child. By 2 ½ years most children can exert some self-control over their impulses. As you think about helping your child develop this capacity for self-control, it is important to be mindful of not just her age and stage of development, but also her temperament.

How does my child's temperament fit into her understanding of "NO!"?

While all children benefit from clear rules and consistent limit-setting so they know what to expect, and so they can make good decisions for how to behave, we need to adapt our strategies based on what we know about how our children typically approach the world. For example, feisty toddlers who are very persistent and intense emotionally may need more guidance and limits set by parents and caregivers. They also need consistency more than others. They are the kids who remember the one time you gave them that one extra cookie and will not let you forget it-pushing and pushing for that extra treat for months to come. On the other hand, laid back kids, who go with the flow, are more likely to accept changes in the rules; they don’t question that one day they get to watch one video, and the next they get two. Knowing what makes your child tick equips you with the best information for developing successful limit-setting strategies.

early child development

Tactics to Help Early Child Development

In the meantime, parents can encourage dexterity with inexpensive homemade games and toys. Keep in mind that children learn by touch, and smell, and taste, as well as hearing and sight. So to help a young child learn to write, spread shaving cream on a tabletop and let him or her "draw" in it, Dr. Patterson advised. Old squeeze bottles make tub toys that improve hand strength. Even popping plastic bubble wrap can help improve finger coordination, as long as someone supervises for safety.

Happily, doing chores is also a skill-builder. Folding towels, putting silverware into the proper bins, and helping set the table all improve physical control. So do learning to spread butter with a knife and helping with baking by stirring, pouring and scooping. Sweeping the floor helps develop coordination on both sides of the body.

To help eye-hand coordination, cut an empty laundry detergent bottle in half and use the part with the handle to catch beanbags. Tape an empty paper towel roll upright on a board, and use it as a ring toss peg.

In addition, Dr. Patterson said, parents can check out toys from a library at the Cincinnati Center for Developmental Disorders at Children's Hospital Medical Center of Cincinnati to give the more expensive toys a test run before purchase.(early child development)

Baby's Development

From the sidelines of any preschool soccer game, it's easy to see the differences in children's physical abilities: Some 5-year-olds look like miniature pros -- kicking, feinting, shooting, scoring, with grace and ease. Others kick the dirt instead of the ball, trip rather than sprint, and send the ball into the cheering section instead of the net.

Both levels of ability are normal. But such wide variations prompt many parents to wonder whether their children's physical development is on track, or off.

Steps to Baby's Development

"Part of it is probably the person's innate 'wiring,' " said Bonnie Patterson, M.D., developmental pediatrician at the Cincinnati Center for Developmental Disorders of Children's Hospital Medical Center of Cincinnati. "The brain is an extremely complex organ we have barely begun to understand."

Developmental experts do know, however, the steps children go through from birth onward as they learn to control their bodies. "It's not a race, it's a progression. A child should reach each milestone in order, rather than at a particular age," said Dr. Patterson.

For example, babies develop from the head down. So, they should first develop head control, as they learn to turn their heads toward sounds. Then they begin gaining control of their trunks, learning how to roll over, for example. Most sit unassisted between about 6 and 7 months. Between 9 months and a year, babies learn to crawl. Then they pull themselves upright, learn to cruise, and finally, between about 9 and 14 months, walk. But children cannot walk if they have not first mastered sitting upright, Dr. Patterson pointed out.

After toddlerhood, children refine their early skills. The key for parents is to track the child's progress with their doctor, who will look for causes if the child falls behind normal ranges, she said.

insect sting allergy

Many people are allergic to stinging or biting insects, including bees, wasps and ants.

Bees and wasps typically do not sting people unless they are bothered or frightened. To help prevent stings, when you're outdoors, forego brightly colored clothes and floral patterns as well as scented cosmetics, perfumes and colognes. Make sure your children wear shoes when walking and playing outside. And keep food and garbage covered so as not to attract the pests.

Small, local reactions to insect bites or stings are symptoms limited to the immediate area surrounding the bite or sting. They consist of short-lived, painful, itchy hives.

If the stinger is visible, remove it by "flicking" it out with a credit card or driver's license, not by squeezing. Treat local reactions with ice or cool compresses, calamine lotion, topical corticosteroid creams, oral antihistamines and Tylenol^®. A mixture of one part meat tenderizer to four parts water can also relieve discomfort.

More significant reactions can involve hives over more extensive parts of the body, gastrointestinal symptoms (vomiting or diarrhea), cough, swollen lips, shortness of breath or breathing difficulties.

When systemic (or body-wide rather than site-only) reactions progress to the point of wheezing, shortness of breath or difficulty breathing, anaphylaxis ('anna-fa-lax-is') is occurring.

If your child ever has wheezing or difficulty breathing after an insect bite or sting(insect sting allergy), seek immediate medical attention. Call 911 or take your child to a hospital or to his or her pediatrician immediately. The doctors will assess your child's breathing and determine if your child needs a breathing treatment, or possibly even a shot of epinephrine (adrenaline) to help stop the allergic reaction.

If your child is diagnosed as having an insect sting allergy to bee stings, your doctor will need to prescribe several 'epi-pens' for you to have (one for home, one for school and one to carry with you) in case your child gets stung. Your child's pediatrician might also recommend evaluation by an allergist.

While some insect bites and stings are inevitable during childhood, it nevertheless is helpful to be aware of basic measures you can use to prevent as many as possible, and to treat those that do occur.