Pediatric Advice

Su Laurent answers some medical questions, such as nutritional questions.

Emma Howard: Hello and welcome to baby talk, I am Emma Howard, and today we’ll be concentrating and answering all your baby related questions in our baby channel mail bag, later on midwife Su Mc Donald will be here to answer your questions. But first I am delighted to be joined by baby channel medical adviser Dr. SU Laurent. Hello, Su Laurent: Hi Emma Emma Howard: Thanks for coming in to us. We have got lots of questions, and teach the manners on to get through them how. Su Laurent: Great Emma Howard: So lets start of with one a new mom clearly a new mom here and she is got a 5 week older a girl and she is asking you why where my 5 week old daughter drink water. I tried it with without sugar warm and cold is there one sort of tip that’s safe and her name of Karen. What would you say to Karrie? Dr. SU Laurent: I would say Karrie don’t worry, you don’t need to give your 5 week old baby water, and milk of either breast milk perfectly breast milk or formula milk is fine,. And its fine for several months, you really don’t need to add any water in at all. Emma Howard: Because its hydrating isn’t it. Dr. SU Laurent: Yeah Emma Howard: The milk is giving them everything they need. Dr. SU Laurent: Everything, everything comes with the milk. Emma Howard: And particularly breast milk, and at make sometimes breast milk seems thin, but it is just what the baby need. Dr. SU Laurent: Just what the baby needs. Emma Howard: So don’t worry. Dr. SU Laurent: Don’t worry stop it. Emma Howard: Don’t worry Karen Stop it, Stop giving water to for your child. The second question, I see somebody with a six week old daughter that who love to get a is there an alternative to water she is asking my six week old daughter is always sick with that, so same answer. Dr. SU Laurent: Well, same answer exactly, don’t worry about it and I think its only really in very, very hot countries where your baby may be loosing lots of extra water that you might advise a little bit of water. But particularly if you are breast feeding, I mean please just give breast and don’t give anything else. Emma Howard: Yes, yes trust in it completely. Dr. SU Laurent: Exactly. Emma Howard: Rights moving on then here’s an interesting question. Can I have some information please regarding strawberry birth marks? My baby has 2 one on her face and one on the side of her head. Dr. SU Laurent: Right. This is one of the often really worries parents, can be very upset in particularly face growth. I thing people get very upset. Please don’t worry, because strawberry mark is go away by themselves, they don’t need any surgery and they disappear so that they are always completely invisible. And I would say in most cases completely invisible. Emma Howard: It’s because they shrink. Dr. SU Laurent: They shrink and they peel after few days or weeks of life time and not there at birth they get bigger and bigger and they can look quite enormous and they do look like a strawberry which is why they call strawberry marks. Emma Howard: And I am shocking to look at because they so broad reds and they catch your eyes. So for parents they really worry Dr. SU Laurent: Exactly, exactly, and exactly. Emma Howard: So for parents they really worry. Dr. SU Laurent: But in less than some where, which is threatening some a vital part of the baby such as vision. I mean occasionally this is strawberry mark near the eye, you may need to have some sort of procedure to make against smaller, and so that the eye that the vision is spared. But mostly strawberry marks on anywhere important they just they just look horrible but they can be often on the head or the neck on the body, the best thing to do is wait, because the best cosmetic result is a cheap by doing nothing and eventually little white line start form across them they shrink away they become completely flat and all you can see is a slightly pale a bit of skin if that will nothing at all eventually. Emma Howard: And then you will be looking for as mom or dad but no one else will notice it. Dr. SU Laurent: No one else will notice it. Emma Howard: why they come in the first, what’s all of they? Dr. SU Laurent: They are the over growth of blood vessels and who knows why they come? It seems to be slightly more common in premature babies, we see them a lot on the unilateral unit but who knows why they come? Some babies have them some don’t but they are harmless and they are not in any way going to be a long term problem to the baby. Emma Howard: I think when they are named beautifully, because it such an innocent name. And that’s not their problem it’s very appropriate. My seven week old baby cries uncontrollably when awake and I’ve taken him to the GPM has told he is got a bad temper. Should I leave him to cry? Dr. SU Laurent: Oh, Dear that is a horrible doesn’t it. Emma Howard: Seems like kind, so such it is the may Dr. SU Laurent: Exactly, exactly, I mean I would say that the interesting facts about uncontrollable crying all that you have to the baby has to cry for more than 3 hours in 24 have to call it excessive cry. Emma Howard: Oh really. Dr. SU Laurent: So basically it’s quite a lot isn’t it 3 hours of solid crying in 24, and most babies actually don’t cry that much, I mean I think the important thing is that I have seen babies cries for reason usually. So you know you usually try to levantate the problem are they hungry, are they in pain. Emma Howard: If there were any nappy change. Dr. SU Laurent: And then even nappy change all those things, some times the crying baby who just cries and cries and cries and you can’t find the explanation. As she just needs left in peace. And we tend to giggle them around and laugh a lot. And I certainly say because in my cases are really irritable baby coming to see me in clinic or in causality, and we see the best for a parent jiggling, jiggling, jiggling walking around, and some times I simply I will just calmly holding them and calmly putting them down and being very quite with them sometimes they will settle quite quickly. Emma Howard: So a very obvious thing that you never thing of it is a close parent, you are thinking, the last thing they wanted to be separated from me, and you are saying sometimes actually babies saying please go away, Just far away. Dr. SU Laurent: Yes, Just go away, or just hang them over sometimes you know you get a lovely kind of warmness in the ANE department because the parents are desperate, and they’ll just take hold of them and suddenly the baby will just relax, its quite interesting. Emma Howard: Great for the baby, but it’s published still for the parent to go happy to see the instead of crying but not happy to some one else child. Dr. SU Laurent: Well that’s the point to the parent to go get a large gin and just relax and chill out. Emma Howard: Now that question didn’t actually say whether the baby was crying when held when put down because some parents have a baby that cries when the baby is put down, so you would never stop holding your baby and that’s a big problem. Dr. SU Laurent: That’s a big problem as well. And that baby really needs to be trained to know its okay to lie down, and to be put to be put down and encourage put down. Emma Howard: Do you think routines are good. Dr. SU Laurent: Routines are good for babies I mean I think you can go over above routines, and there is certain people obligate very strict routines, which I feel I am fed I am one of them. But I do think an relevant of routine is very health take your bed time routine is very help full. Emma Howard: Right so you are not of full time. Dr. SU Laurent: I am not, I burnt my book. Emma Howard: Oh did you? I have certainly like t think, you need be an independent mind. Dr. SU Laurent: Well I think its fine because it’s your first baby and you got nothing else to do, or if you have got some help. Emma Howard: And then you think it come along. Dr. SU Laurent: Yeah, but I think other wise if you have got 2 or 3 and you are trying gene afford a baby was leading a life for the others. Emma Howard: I think adopt test see that either find to do adopts but I do think it needs to be certain comfort and rate to that she is fabulous I have to say all the time but I know that certainly with the bit was the -- and I thought that they were fabulous too didn’t like at all course is for courses finding her own way is so difficult. Dr. SU Laurent: Exactly. Emma Howard: But advisor when is that so much you are able to go no that I am going to do that beside but a lot, lot better of it. Dr. SU Laurent: I am thinking taking it for you a lot. Emma Howard: This is very good idea, Here we have but the questions that we have here my baby boy is 9 months old , and I still cant get him interested in solids. Now do I need to be worried or is he still getting enough benefit from breast feeding. She doesn’t say of course how much milk she is giving him and back can be problem I know because. Dr. SU Laurent: Well, I think there is a very clear answer here, which is beyond the age of 6 months you do need to introduce solids because you don’t get enough nutrition at 9 months from just breast milk. And if fact we seem to be seem more and more babies who have low levels of calcium, and getting rickets, and rickets is very out fashioned disease. Emma Howard: Yes, victory of -- Dr. SU Laurent: It is and I cant tell how many have seen recently actually and they tend to be in the exclusively breast fed baby they the come in as about a year or so, and they are more or less getting nothing but breast milk and they some times have also have mumps who are getting much calcium much but Vitamin D for example mumps who have the bodies completely covered or it’s a winter time and there is no much in light coming and converting that not much of sunlight. So those babies actually you do need to think about solids, now you health visitors going to be the most helpful person to get babies on to solid to really encouraging how do it. Emma Howard: There is an eighth month check because there -- Dr. SU Laurent: Exactly I’ll ask you about at home what you’re giving how much the bottom line with babies we would take spoons that approach the mouth them out and you forgets spoons remember hands. Emma Howard: Don’t be afraid of the mess. Dr. SU Laurent: Don’t be afraid of the mess, because one thing I say to parents again and again and again it is a yucky stage you have to go through. The obsessional type of mother often finds that stage of feeding really difficult. Emma Howard: Certainly you love your kid should know -- yes, yes quiet a lot to go. Dr. SU Laurent: Mess is the odor of the day, and those babies are really have fun with food and putting in their mouth and will learn how to eat solids. Emma Howard: That’s a really good piece of advice. So any way you have to kind of talk to yourself first. Dr. SU Laurent: You do. You do. Luckily I am not an obsessional mother so I they messed me with just fun, but to some period for people its very difficult. Emma Howard: Although once you see the joy on their faces when they got finger food pretty ever they’ll look at floor just look at them. Dr. SU Laurent: Just cover the floor with plastic and just make sure it’s just fairly sort of it’s azole in house, which is okay, but if it gets messy. Emma Howard: And then now that you will eventually move on the spoon. Dr. SU Laurent: Yeah. Exactly, exactly. Emma Howard: Well that’s a very good piece of advice. Some body here is having trouble with a 6 month getting them off the breast and to the bottle and obviously its actually quite common isn’t it, it’s that going from the nipple to plastic. Dr. SU Laurent: Yes Emma Howard: Do you have an any tips. She wants to know. I would like to get back to work, but rather I feel I can, until he is on the bottle. When clear she is at this stage I am sure you to advice people starts bit earlier so that they have adopted this position, but if you are. Dr. SU Laurent: It’s a very common stage, the best thing is to take your self in to some lovely place for the day, and leave your baby with some one else. Emma Howard: He doesn’t smell of your breast milk. Dr. SU Laurent: And say If you can you know get your partner stay home for a day over friend or what ever and just take yourself give yourself well break, take him often some one lovely get pampered, have a massage what ever, oh going to swim go see your friend have a few cups of coffee what ever. Just you have to my message is that just you must not be there, because as far as long as your baby can smell your milk, your baby will just reject that bottle. Emma Howard: Now what about all the women just watching you took about this now and hear to the earliest stage, are think yeah I want to go back to work at 6 and their are few weeks old at what stage is good a time to introduce may be one feed of breast milk in a bottle. Dr. SU Laurent: Well what I would say if you if you need to get your baby really well established on breast feeding, before starting with the bottle ideally. This is and ideal once. Emma Howard: What would you do one feed a day, a late feed by the partner or --? Dr. SU Laurent: I would say may when they are when they are really was beyond 6 weeks old, when then really well established on breast feeding, and it is easy to breast feed and that’s fine that one feed a day is great one to get a partner to do. Emma Howard: So you think may be seven or weeks eight weeks. Dr. SU Laurent: Some thing like that would be ideal, some thing like that ideal, and then you’ll have a little bring can may be that’s the time for job with the baby sitter, leaves and leaves the best breast milk with the baby sitter. Go out and have a little break. Emma Howard: But going out and having a baby sitter a month and couple of months of weeks, if you if you are lucky where as having that one feed regularly, it will be best to give him by the opponent, the person who doesn’t smell of your breast. Dr. SU Laurent: Exactly, exactly inform for them. Emma Howard: Inform to the baby. Dr. SU Laurent: Inform the baby form for the partner. Emma Howard: Oh inform for the partner wonderful perfect time. Dr. SU Laurent: It’s a lovely thing to see this it’s actually as treat a baby. Emma Howard: So using that 7, 8 weeks. Dr. SU Laurent: Yeah Emma Howard: That’s a good time start doing it. How can I best get my one year old offer formula milk to full fat milk, actually you would remind us when can they drink cows milk ? Dr. SU Laurent: Right one year is the usual age as recommended never ever before 6 months, and 1 year she is usually good age because formula milk is reinforced with all sorts of things like iron vitamins, and so that until you got your baby well established on solids, you know that the formula milk is going to contain lots of extra good deeds and that’s what you are giving at that stage, but a years absolutely fine. Emma Howard: Because that from the foods providing all that. Dr. SU Laurent: Now the thing about door step milk, after a year is that we always give full fat milk but actually why full fat milk, in what ever we saying the children get too much fat in their diet and its just as much calcium vitamin D and semi skimmed milk. So why have she never given my children full fat milk. I have always just giving them what we have it which is the semi skimmed milks and is just has got full fat. Emma Howard: And do you think that organic milk that some people of have suggested is easier to digest? Dr. SU Laurent: No evidence for that. Emma Howard: Right Dr. SU Laurent: But I know of any way. Emma Howard: So it’s just a -- Dr. SU Laurent: it’s justly if you are an organic kind of family then go through organic milk. By that thing is anything about digest in this different in it. Emma Howard: But you said and I think its fine to give chosen semi skimmed milk. Dr. SU Laurent: Absolutely yes. Unless there is a weight problem and is that really amazing really under weight. Emma Howard: Yes then you are trying to find them up. Dr. SU Laurent: Then we are trying to find them up but otherwise most of our children don’t need -- Emma Howard: Rest of us tries to carry other way. When does your breast feeding why when you are breast feeding that’s it? So reading the question wrong, why when your breast feeding does the feed seems to take hours. And they never seem satisfied and that clearly it’s a problem with some people do have when they are breast feeding their babies. Dr. SU Laurent: Right, it may well be that the babies getting all the nutrition’s they need in the first 10 minutes, once when well establish breast feeding this is and then after that the baby just having a jolly good nice suck, because babies love sucking on the breast I mean its a lovely feeling being, Emma Howard: And the best place to being especially for the sleep. Dr. SU Laurent: Best place to be, exactly. Emma Howard: For them not for you. Dr. SU Laurent: So the thing about breast feeding should begin with is it all some takes a long time to get established they often takes in you, you feeds going to be quite long it might be half an hour per feed and you might be feeding every 2 or 3 hours and you know that might seem like for ever. But once they are well established they probably going to get most of the nutrition in the first 10 or 15 minutes, and then you can decide whether you know say okay you fed enough baby or you let him just coming out sucking for a bit. Emma Howard: Yes firm loving. It’s often because appropriate. You must be all through the time setting of being 10 hours what food should average and breast feeding when can starts from the basic and because -- Dr. SU Laurent: You certainly do I mean personally I must say the old glass of wine, well a glass of wine every evening is what I had as soon as I started you know as soon as I have the baby each time I said right I am back in now the glass of wine of evening. Emma Howard: And that’s great. Dr. SU Laurent: And your point is lovely and Guinness has always been apprehended hasn’t it for the best feeding mothers stout. Emma Howard: the best feeding mothers stout. Dr. SU Laurent: So yes so that’s fine, I mean some mother’s fine, that a few things are lot of grapes. That can give their baby bit of diarrhea. But mostly I would just take what in fancy and then see and if you think if you have certain offer some people say. Keep the baby a bit of alcoholic, but just I just suck it and say and I would do what ever you want to really. Emma Howard: Yes and not to be too obsessional among that. Dr. Su Laurent: Don’t be too obsessional relax. Emma Howard: Relax. Dr. Su Laurent: Yeah Emma Howard: As you need do need to yourself as well. Dr. Su Laurent: You do, you do. Emma Howard: As long as you are not too touching reaching them off because that would be appropriate if you are eating it enough. Dr. SU Laurent: Exactly and drinking plenty of water as well. Emma Howard: Lots of this also more to feeding the baby. Have that glows that. Dr. SU Laurent: Exactly, exactly. Emma Howard: Yeah very important this is an absolutely fascinating question, I would love to be the person who said is it dangerous to have tattoo while breast feeding. Just as well it raises no full of images in my mind to now while breast feeding. Dr. SU Laurent: When the tattoo is shop on she breast feeding and it’s being done. Emma Howard: I would say childish is but so she wants to have a tattoo and she is still breast feeding baby until not station. And I think she should wait till she finished. Dr. SU Laurent: It’s a question I have never been asked before. Emma Howard: Now I can imagine you having it. Dr. SU Laurent: I can’ say any particular reason not to do, I mean obviously That they need real danger of a tattoo. Is if it’s done with needles which of have been they have been used by some body else. Emma Howard: Which will be initiate with your breast feeding who knows? Dr. SU Laurent: May they breast feeding or not. So you know it this Hepatitis B, Hepatitis C type of thing. But obviously you know most respectable tattoo places they will use one certainly needles I imagine all stabilizing or what ever Emma Howard: I am wondering if she is thinking that the ink might be some more how you know in full traces in body but it just wouldn’t be. Dr. SU Laurent: Its not that I know, but I must say this is no areas but it that I have a say a probably do a quick internet search for that but I have never ever heard it that is the contradiction. Emma Howard: So right so you’re saying so do it if you want to. Dr. SU Laurent: If they really want to yes. Emma Howard: Well I have been How we can better that question, that was a brilliant question I knows always ask personal experience question never been asked before lovely I am delighted about that so we have more questions and another time we’ll get to do them. Thank you very much. Dr. SU Laurent: A great pleasure. Thank you. Emma Howard: Now if you have anything you want to put to our experts here with the baby channel then do get in touch. You can call us on 0905 028 0090 and leave us a voice mail If you and that’s 09050280090, or you can send us text message just text the word baby plus your message to 82540 another way you can get in touch with us is to send us photographs of your baby which is exactly what the parents of these little ones have done.