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Health and Medical Q & A
as printed in the December/January 2007 issue of Island Child
Q: Does my toddler need a multi-vitamin?
A: Vitamins are necessary for a child’s normal growth and development. Generally speaking, vitamin
supplementation on a regular basis is not needed. If a child is breastfed, the mother’s milk contains
the necessary vitamins, except for vitamin D, which should be given as a supplement as directed by
your caregiver. If your child is formula fed, the formula would contain all the necessary vitamins and
minerals. If your child is over nine months and is being given whole cow’s milk, the baby will need a
Vitamin C supplement until it can be obtained from food sources such as fruits. After the age of 1, your
child should have a diet consisting of foods from each of the four food groups listed in the Canada Food
Guide to Healthy Eating. This diet would ensure that your child is receiving the recommended daily
vitamin and mineral intakes.
If your child is particular about what he eats, don’t jump to the conclusion that he is not getting enough vitamins or
minerals. Many foods are fortified with important vitamins and minerals that your child would be receiving. Children do
not need large amounts of vitamins or minerals. However, if your health care provider recommends that your child begin a
multivitamin make sure you choose a multivitamin formulated specifically for children, the vitamin is always administered
by an adult and to keep the bottle of vitamins out of your child’s reach. Your child should also be taught that a multivitamin
is medicine, not candy! Most importantly, giving a multivitamin is not a replacement for proper nutrition and balanced
meals.
Ted Carino is the Pharmacist at the Peoples Pharmacy in Mill Bay.
Q: I’m worried about going overdue. Can being overdue be harmful to my baby?
A: Most doctors will start monitoring a baby through ultrasound once the baby is a week overdue
and will ask you to do kick counts to monitor your baby’s activity level. If at any point your
doctor concludes that your baby would be better off being born than remaining inside the womb,
the decision will be made to bring on labour sooner rather than later. In the meantime, try not
to worry if your baby is merely fashionably late.
Ann Douglas is the author of The Mother of All Baby
Books and the newly-published Sleep Solutions for Your Baby, Toddler, and Preschooler
and Mealtime Solutions for Your Baby, Toddler, and Preschooler. Read articles by Ann Douglas at
www.having-a-baby.com.
Q: I am pregnant and have a tattoo - now what?
A: A pregnancy will affect your tattoo in different ways,
depending on the placement. If your tattoo is near the stomach area, not only
can it stretch, but there is no guarantee that it will go back to its original shape after the birth of your baby. Tattoos
are definitely affected by stretch marks. Chances are if your mother or grandmother
had stretch marks, you will too. If your tattoo is in the small of your back, it should not prevent
you from getting an epidural. The ink from the tattoo is a permanent part
of the dermis of the skin. The epidural needle passes through the epidermis, dermis and into an area near your
spinal cord quite easily. You might want to consult with your doctor and
anaesthesiologist to see what they recommend if you have concerns.
For more information on tattoos or body piercings and how they will
affect your pregnancy, talk with your healthcare provider
Health and Medical Q & A
as printed in the August/September 2006 issue of Island Child
Q: A friend told me that it’s possible to predict my baby’s sex based on the fetal heartrate. Is this true?
A: The myth that you’re referring to says that if your baby’s heartrate is under 140 beats per minute, you’re having a boy, and if it’s over 140 beats per minute, you’re having a girl. Although this particular myth has been kicking around for decades, there isn’t much hard evidence to support it. In fact, there’s only one study on the books that seems to lend any credence to the theory at all: a 1993 study at the University of Kentucky that concluded that the fetal heartbeat could be used to correctly predict the sex of 91% of male fetuses and 74% of female fetuses. Given that every other study on the books has reached the exact opposite conclusion, I wouldn’t paint the nursery pink or blue on this basis!
by Ann Douglas, Author, “The Mother of All Baby Books”
Q: As an adult, I am plagued with seasonal allergies. I find my daughter has a frequent runny nose and itchy eyes; signs of her own allergies. What do you give a small child to treat seasonal allergies?
A: An allergy is a response by your body’s immune system to something that is ordinarily harmless, such as pollen, animal dander or dust. Typical signs of allergies are itchy, runny nose, nasal congestion, itchy, watery eyes and sneezing. Prompt care and treatment can help treat allergy symptoms. Non-medicinal approaches will help control allergic symptoms. Avoid line-drying clothes and change clothes after being outside for longer periods. Keep windows closed and use air-conditioning instead. Keep your house smoke-free. Irritants like tobacco smoke can intensify allergy symptoms. Dust avoidance measures can reduce exposure by as much as 60%.
The use of non-prescription antihistamines can help relieve all of the symptoms of allergies. The older antihistamines typically may cause drowsiness, which could persist into the next day. An opposite effect can occur in a small percentage of people where they would become over stimulated. The newer antihistamines are generally non-sedating and can be taken once daily. For children 2 years and over, liquid preparations containing loratadine, desloratadine and cetrizine can be used. For children under 2 years of age, the use of saline nose drops and allergen avoidance techniques would be preferred however, diphenhydramine may be also be recommended by your healthcare provider. For maximum effectiveness, begin using antihistamines before the allergen exposure and take regularly until end of season.
by Ted Carino, Pharmacist
Q: Is breast feeding better than bottle feeding in preventing childhood cavities?
A: Breast milk and formula both contain milk sugars which cause cavities. When comparing breastfeeding to bottle-feeding for cavity risk alone, there is no advantage to breastfeeding over bottle-feeding other than being present to stop the feeding. However, at no time is it advisable to put your child to bed with a bottle as this will cause cavities. Conversely, it is not ideal to have your baby sleep with you nursing throughout the night because this will also lead to cavities. If possible, it is best to try to wipe out your child’s mouth with a clean, soft cloth to remove any milk residue after feeding. This will help prevent cavities on those newly erupting teeth!
by Dr. Joey Dahlstrom, Dentist
Health and Medical Q & A
as printed in the June/July 2006 issue of Island Child
Q: What do you recommend giving an infant for a cough?
A: The most common non-prescription cough medicine is called Dextromethorphan or DM for short. It can be found alone or in combination with other ingredients. Generally speaking, treating an infant’s cough (less than 2 years old) with DM is not recommended due to the lack of proven effect in infants. For children 2 to 6 years of age, 2.5 to 7.5mg every 4 to 8 hours as needed or 15mg every 12 hours as needed with sustained-release suspensions such as Benylin Nighttime for kids. For those children ages 6 to 12 years, 5 to 10mg every four hours as needed or 30mg every 12 hours as needed for sustained-release suspensions. A cool mist humidifier may help your child sleep through the night or a 20 minute steam bath may also help soothe a barky cough by increasing the humidity. Increasing fluid intake can help thin out phlegm thus taking away some severity of the cough. If the cough does not seem to go away or gets worse, a trip to the doctor may be in order.
by Ted Carino, Pharmacist
Q: My son is almost 2 1/2 years old and has not shown any interest in learning how to use the toilet. My mother insists that I was toilet-trained shortly after my first birthday. Is there something wrong with my son?
A: Given all the time and energy some parents (and grandparents!) put into obsessing about toilet training, you’d think researchers had uncovered a link between the age at which a toddler is fully trained and his law school entrance exam scores two decades later. But since no study to date has been able to demonstrate that kind of connection, I would urge you to do yourself and your toddler a favor and chill out about the whole potty training business! Of course, that’s easier said than done if all the other parents you hang out with are potty-mad ~ and chances are they are!
A recent study found that 65% of moms felt pressured to toilet train their toddlers: 32% because of their child’s age, 26% because of pressure from relatives or mothers with toilet-trained children, and 15% because a particular daycare or preschool program required that children be toilet-trained prior to enrolling. Do you have anything to lose by trying to jump-start the process a little early? Yes, according to the experts. One study found that children whose parents started trying to train them at age 18 months typically weren’t trained until four years of age, whereas children whose parents started training them at two years of age were typically trained by their third birthday.
by Ann Douglas, Author, “The Mother of All Baby Books”
Q: Should fluoride be given to toddlers? There seems to be a lot of contradicting information on this.
A: The only fluoride to give toddlers would be in toothpaste. A smear across the width of the bristles is all that is needed, twice a day. It is now known that the greatest effect of fluoride for cavity prevention is on the teeth in the mouth, not as much on the unerupted teeth. Therefore, supplementation is aimed at bathing the teeth in the mouth with fluoride versus solely ingestion. Yes, there is a lot of contradicting information out there. One of the concerns with fluoride is too much fluoride. If too much fluoride is given while the teeth are developing, the teeth will demonstrate fluorosis – in its mild form shows as white spots on the teeth, the more severe form shows as brown spots within the enamel of the teeth. Parents should supervise tooth brushing until the child is eight years old.
One thing to note is that very few communities in BC add fluoride to the municipal water. Call your local health unit to find out if your community has a water fluoridation program. Supplementation may be recommended for your child if he or she is at great risk for cavities.
by Dr. Joey Dahlstrom, Dentist
Health and Medical Q & A
as printed in the April/May 2006 issue of Island Child
Q: When should I bring in my child for her first dental check-up?
A: The first dental check-up should be done within 6 months of the first tooth erupting or by one year of age. This is a relatively new recommendation aimed at prevention. This first check-up would include an examination of your child’s teeth, discussion of diet for the child and tips on cleaning your child’s teeth. If you notice white or brown spots on their teeth, call your dentist right away.
Q: At what point do I take away the soother permanently as to not cause any damage?
A: Ideally, a soother should be taken away before the first teeth erupt. However, if it is removed before the age of three there should not be any permanent damage such as tooth movement or speech changes.
by Dr. Joey Dahlstrom, Dentist
Q: How long does a breastfed baby have to take Vitamin D drops for? My son is 8 months old and he is eating solid foods now but we are
vegan, so he is not having any dairy products which have Vitamin D in them. Once he can have soy products I know there are fortified soy products so is that when he can stop, or should he continue on taking the drops?
A: Vitamin D refers to a group of fat-soluble sterols, which are needed for regulating calcium, phosphate and bone minerals. Vitamin D is essential for bones and teeth to grow strong and healthy. Vitamin D is given to infants to prevent rickets, a severe prolonged Vitamin D deficiency that leads to softening and weakening of the bones. Sources of dietary Vitamin D include margarine, salmon, tuna, fortified milk and formula products.
Infants at greatest risk of vitamin D deficiency are those who are exclusively breastfed, not exposed to sunlight or are dark skinned. Breast milk is not a reliable source of vitamin D as it only provides 15 to 40iu of vitamin D per liter. If the mother herself is low in vitamin D, this further reduces the vitamin D content of breast milk. The Canadian Pediatric Society recommends that all breastfed full term infants receive a daily vitamin D supplement of 400iu, which should continue until the diet provides an adequate source of Vitamin D.
by Ted Carino, Pharmacist
Q: What exactly does a midwife do?
A: Midwives manage prenatal care for low risk clients. We schedule longer appointments to discuss test and procedures. We order lab work and ultrasounds. We remain throughout active labour to monitor and provide support. Midwives deliver babies at home and the hospital (the client chooses the location). Afterwards, midwives come to your home for six weeks helping with breastfeeding and newborn care.
Q: Does a midwife have the same 'privileges' as a doctor when it comes to delivering a baby in a hospital?
A: Yes, Midwives however, stay to manage the labour and birth at the hospital. With physician care, the woman is assigned a nurse, the doctor is kept informed regarding her progress and remains when she begins pushing. If complications develop, the midwife or doctor will contact an obstetrician. These specialists perform procedures such as Cesarean Sections. The midwife remains involved to provide support.
by Jenn Hewko, Registered Midwife
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