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Baby Q and A with Dr Tanya Altmann

New parents understandably have many questions about caring for their newborns. Pediatrician, Dr. Tanya Altmann responds below to parents frequently asked questions.

What is SIDS?

SIDS stands for Sudden Infant Death Syndrome. SIDS is the unexplained death of an infant younger than 1 year. A baby is at greatest risk for SIDS between 2 and 4 months of age. Although the exact cause for SIDS is unknown, there are ways to help your baby sleep safely (see below).

How can I ensure that my baby sleeps safely?

ALWAYS: 

  • Place baby to sleep on his or her back at naptime and at night time.
  • Use a crib that meets current safety standards with a firm mattress that fits snugly and is covered with only a tight-fitting crib sheet. Place your baby's crib near your bed.
  • Remove all soft bedding and toys from your baby's sleep area. The American Academy of Pediatrics suggests using a wearable blanket instead of loose blankets to keep your baby warm.
  • Breastfeed, if possible, but when finished, put your baby back to sleep in his or her separate safe sleep area alongside your bed.
  • Offer a pacifier when putting baby to sleep. If breastfeeding, introduce the pacifier after one month or after breastfeeding has been established.

NEVER:

  • Never put your baby to sleep on any soft surface (adult beds, sofas, chairs, water beds, quilts, sheep skins, etc.)
  • Never dress your baby too warmly for sleep; keep room temperature 68-72 degrees Fahrenheit.
  • Never use wedges or positioners to prop your baby up or keep him on his back.
  • Never allow anyone to smoke around your baby or take your baby into a room or car where someone has recently smoked.

Where is the safest place for my baby to sleep?

The safest place for your baby to sleep is on her back in her own crib or bassinet in the same room as you. Side sleeping is no longer recommended as a young infant can easily flip onto his tummy. Do not allow your baby to fall asleep in your bed, as this is a risk factor for suffocation or SIDS. Make sure that there are no loose blankets, pillows, soft bumpers or other toys in your infant’s sleep space.

Should my baby use a pacifier?

Recent research shows that pacifiers offer a protective effect against SIDS. Although the mechanism is not known, the evidence is strong enough that it is now recommended that pacifiers may be used during the first year of life when placing your infant to sleep. The pacifier does not need to be reinserted however once your infant falls asleep. If you are breastfeeding, delay pacifier introduction until breastfeeding is well established, usually around 1 month of age. Make sure pacifiers are cleaned and replaced on a regular basis. If your infant does not like a pacifier, there is no need to force it.

When can I give my baby "Tummy Time"?

Although your baby should always be put to sleep on his back, while your baby is awake, it is important to give him plenty of supervised "tummy time". Spending time on his tummy while awake will help him learn to lift his head, a movement that strengthens the muscles of the neck and upper back. Babies who are frequently placed on their stomachs while awake often achieve head control earlier than those who spend most of their awake time lying on their backs. You can help encourage your baby to lift his head by talking or singing slightly above his head. As he gets a few weeks older, place a bright colored toy in front of him to grab his attention. After he learns to lift his head slightly up, move the toy higher and from side to side. This will encourage him to look at and follow objects as well as to develop head, neck and upper body control.

How can I prevent my baby from getting a flat head?

Plagiocephaly is the flattening of one part, usually the back or side, of an infant's head. This sometimes happens when a baby's relatively soft skull bones are in contact with a flat surface such as a crib, bouncy or car seat for too long. To prevent this, make sure to offer your baby plenty of supervised "tummy time" while she is awake. This will help strengthen her head, neck and upper body. In addition, while your baby is on her back, alternate the side to which her head is placed. If you notice that your infant's head is getting misshapen, talk to your pediatrician. He or she may make other suggestions such as alternating the side that you feed and burp your baby on, placing a brightly colored object or slightly tilting the crib mattress to force your baby to look to the less desired side.

How do I choose a pediatrician?

Choosing a pediatrician is a very emotional decision for many parents. This is the doctor who you will be entrusting your precious little one to. He or she will be there to answer your questions, provide anticipatory guidance and regular check-ups and care for him when he is sick. Ultimately, you should choose a pediatrician who you feel comfortable with and who is in a convenient location, hopefully in close proximity to your home as you will be there often during your baby's first year of life.

The best way to obtain recommendations for a pediatrician if often through friends and family members who you trust. You can also ask your Ob/Gyn, regular doctor or the hospital you will be delivering at for referrals. Once you get a few names, schedule a prenatal interview so you can meet with the pediatrician and see the office.

What should I ask a pediatrician at a prenatal interview?

Most pediatricians are used to talking with new and prospective parents and will often answer all of your questions during a short appointment. Ultimately, you want to choose somebody who you feel comfortable with.

Here are a Few Questions to Ask:

  • What are the office hours?
  • What happens after office hours if I have a question or my child needs to be seen?
  • Who covers for you on your days off?
  • Who will answer my questions when I call during and after office hours?
  • What happens at the hospital when my baby is born?
  • Will you see my baby after he or she is born and how often?
  • When should I bring my baby in for the first appointment and subsequent appointments?
  • How do you feel about breast-feeding, sleep, immunizations and other topics?
  • How does the office handle billing and insurance? Do they take my insurance?

Why do babies cry and how do I calm my crying baby?

Babies cry. Sometimes babies cry often. They may cry when they are hungry, wet, cold, or hurt, or even for no apparent reason at all. On average, newborns cry up to 2 hours a day, and over the first few months they may cry even more. If your baby has been fed, burped, changed, and checked to make sure nothing is hurting her, it's generally all right to let her cry for a little while. It may just be her way of blowing off steam, so give her the chance to just let it all out. Over time, some parents and caregivers can learn to distinguish their infant's cries and what they mean, which is often helpful when trying to calm a fussy baby.

How can you help calm her cries?

Try swaddling, rocking, singing, or even making a loud "shhhh" noise. Some babies enjoy moving around as well, so dance or go for a walk. Others enjoy looking in the mirror or at a favorite toy. Talk to your pediatrician if the crying seems excessive or she is truly inconsolable.

What about swaddling?

After being tightly cuddled inside mom for nine months, it's no wonder that some babies enjoy being swaddled after birth. It makes them feel snug, warm and secure. Swaddling can help calm many fussy or crying babies and even help them sleep longer in the first few months of life. In fact, many cultures have been swaddling their infants for thousands of years. There are several techniques and swaddle blankets available to snugly swaddle your infant and as you experiment, you may find out which one your baby prefers for daytime and nighttime.

When is time to stop swaddling?

As your baby grows, he may outgrow his need for swaddling as he may prefer to have his arms free or he may begin to move about in the crib and roll over. It's time to stop swaddling your baby when she starts to show signs of rolling over or breaking out of the swaddle. Most babies are ready to go into a regular wearable blanket by 3 to 6 months at the latest.

 

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