 As recommended by the World Health Organization.
Comments : 1. Thaw ready-to-eat frozen food in the fridge or microwave - don't thaw at room temperature. Yes, it is available in Worcester. A few drops of your baby's blood can be collected onto a blood card in the first few days of life (best on the day of discharge) to screen for a number of metabolic and other inherited diseases (see below for the complete list). As a screening test, the aim is to identify newborns that require further, definitive testing. The benefits include early diagnosis and potential treatment of these relatively rare (1 in 4000 babies affected), but potentially serious and lifelong, conditions. They can be quite difficult to diagnose (if one waits for symptoms and signs to appear) and by the time they are, some of the complications may be irreversible. It is strongly recommended to have the screening test done if there is a family background of one of these conditions. Why isn't everyone having the test for their baby? It is relatively expensive (currently up to allmost R1600) and your medical aid probably won't cover the cost.
Conditions screened for with the newborn screening test : Amino acid disorders : Citrullinemia type 1, classic phenylketonuria, homocystinuria, maple syrup urine disease, tyrosinemia type 1. Organic acid disorders : 3-hydroxy-3-methylglutaric aciduria, 3-methylcrotonyl-CoA carboxylase deficiency, glutaric acidemia type 1, holocarboxylase synthase deficiency, isovaleric acidemia, methylmalonic acidemia (cobalamin disorders), methylmalonic acidemia (methylmalonyl-CoA mutase), propionic acidemia, beta-ketothiolase deficiency. Disorders of fatty acid oxidation : carnitine uptake defect/ carnitine transport defect, medium-chain acyl-CoA dehydrogenase deficiency, very long-chain acyl-CoA dehydrogenase deficiency. Disorders of carbohydrate metabolism : classic galactosemia. Endocrine disorders : congenital adrenal hyperplasia, primary congenital hypothyroidism. Other disorders : biotinidase deficiency, cystic fibrosis. More information : Newborn screening in South Africa Newborn screening in the USA Is it important? Yes. Iron deficiency is common and may have lasting adverse effects on your child’s cognitive abilities. It has also been associated with headaches and the development of ADHD (attention deficit hyperactivity disorder) and strokes in children.
What can we do to decrease the prevalence of iron deficiency? At delivery, your baby’s umbilical cord should only be clamped after 30-60 seconds, if safe to do so for mom and baby. If your baby is at high risk for the development of iron deficiency, he or she needs to be supplemented with iron from 2 weeks after birth. This is especially important for babies of mothers who had iron deficiency during the course of their pregnancy, premature or low birth weight (<2.5kg) babies, and babies who lost blood before (in the womb), during or after delivery. If breastfeeding exclusively, your baby needs to be supplemented with iron from 4 months of age. When starting with supplemental feeds @ 4-6 months, start with an iron-enriched baby cereal and do not wait until after 7 months to start with pureed meats. Delay giving unmodified cow’s milk until after 12 months of age, as its intake before this time can lead to poor iron absorption and silent bleeding in your baby’s gut, with chronic blood loss aggravating the iron deficiency. Toddlers older than a year of age should not be drinking more than 600ml of unmodified cow’s milk per day; if they are and cannot be weaned from doing so in the short term, they should be supplemented with iron. Routine iron supplementation is also recommended if your child (between the age of one and five years) is eating less than 3 portions of iron-rich foodstuffs per day (<85g meat per day). Liver, prune juice, spinach and iron-fortified cereal are some of the less well-known iron-rich foodstuffs. Meat not only contains good amounts of iron, but also inherent factors that promote the absorption of iron from other (non-meat) iron-rich foods. Food elements having a negative effect on the absorption of iron, include tea, coffee and calcium (beware excessive amounts of dairy in the diet). Tea may decrease iron absorption by 90%. Ascorbic acid (vitamin C) promotes the absorption of iron : it is a good idea to give a (diluted) vitamin C-enriched juice with (iron-rich) meals. Children should be dewormed at least every 6 months in the first 5 years of life – the worms attach to the inside of the gut, leading to significant blood loss over time if the amount of worms are enough. Colic is a descriptive, subjective diagnosis : it only means that your young baby is crying excessively in the first few months of life. It is a diagnosis of exclusion : your doctor needs to exclude other potential causes for crying; colic can only be diagnosed once other causes of crying in a young baby have been excluded. Although there are theories surrounding the cause of colic, we actually don’t understand why it happens. There is also no solid medical treatment available that consistently alleviates crying in all babies with colic. One can, however, rest assured that it is a temporary phenomenon – almost all babies with colic stop crying between 3 and 4 months of age.
There is no good evidence that any medication consistently helps with bronchiolitis. A small percentage of patients might improve with a beta-agonist airway muscle relaxant aerosol like Ventolin. Aspelone, nebulised Pulmicort/Budoneb, Monte air/Topraz/Sintrine, antibiotics, nebulised adrenaline, nebulised hypertonic saline, cough mixtures, chest physiotherapy… none has been proven to effect a quicker cure, despite being commonly prescribed and used. Antibiotics are only indicated for severe bronchiolitis. Supportive treatment in hospital entails providing oxygen (if needed), managing fever, ensuring adequate fluid intake and managing complications like otitis media and pneumonia (lung infection). In-hospital stay is usually only necessary for a day or two to gauge the course of the disease process. It may take weeks to resolve completely.
"Fluoride supplements should only be recommended in children with a high caries risk. The decision to prescribe supplements is based on the child’s individual need. It is therefore advisable to consult your dentist before the decision is made to give children fluoride supplements."
The basics. The when, the what, the how much, the do's, the don'ts. Start here before you start.
Breastmilk can be frozen (in a sterilized bottle). If special containers for this purpose aren’t used, you can express into a normal (sterilized) bottle, covering it with plastic or foil to prevent contamination.
How to thaw : swirl bottle with frozen expressed breast milk under running, warm water. Don’t thaw at room temperature : it takes too long, spoiling may occur. Never heat in a microwave. Never refreeze once thawed. How long can expressed breast milk be stored? Fridge ice compartment 2 weeks; freezer 3 months. Wash hands and all feeding utensils well.
Boil all feeding items for 5 minutes. Close cleaned, dry bottles until used. Boil fresh water for 5 minutes; allow to cool down to lukewarm before pouring into bottle. Prepare one feed at a time. Only use the scoop provided with the formula - scoop sizes vary between brands. Read the label carefully to see the recommended volume of the feed according to your baby's age and/or weight and the amount of water to be mixed with a scoop of formula powder. Level each scoop with the back of a clean, dry knife. If formula needs to be warmed, it should be done with a bottle warmer or by placing the bottle in a container of warm water. Do not warm in a microwave (creation of hotspots with the risk of causing burns). Do not warm for longer than 15 minutes (certain bacteria may start to proliferate). An appropriate temperature for the formula is between room and body temperature. Test a few drops on the inside of your wrist to check the temperature before you offer it to your baby. Any infant formula not consumed within 2 hours should be discarded. Leftovers should never be reheated, refrigerated or saved for the next feed. Routine follow-up visits
Follow-up visits of high risk infants and children with chronic diseases are individualised. Routine follow-up of your healthy baby, infant, toddler or child is recommended at the following ages: 6 Weeks 3–4 Months 6 Months (especially for first-time parents) 9 Months 12–15 Months 18–24 Months Yearly after age 2 The idea behind routine follow-up visits is to see the children when they are well and capable of being screened for developmental problems. Time is spent on the little things. Advice on nutrition, supplementation, prevention of common childhood problems and immunization is provided. A quick systemic examination is performed and all measurements are assessed. Time to bring in the little list of questions you have compiled over the last few months! Jaundice
If your baby is jaundiced, be sure to know when your paediatrician would like you to have the jaundice test to be repeated. In general, if the jaundice test was done on the day of discharge from hospital, it is recommended to have it repeated within the next 48 hours. It is also recommended to repeat testing if your baby is still jaundiced after 2 weeks. Feeding And General Baby Care If you experience any feeding difficulties or if you have any questions regarding routine care of your baby, please contact Sr Heidi Jonker on 023 348 1606/ 082 872 9196 for feeding advice and support. Regular Weighing Of Your Baby It is recommended that you have your baby weighed regularly in the first few weeks – weekly initially for the first 2–4 weeks and then biweekly thereafter. Routine Follow-Up If Dr Stander attended to your baby after his or her birth in hospital, you will be contacted to arrange a follow-up visit at the practice within 5 days of discharge from hospital, as well as an appointment for a routine check-up at 6 weeks, usually arranged for the same day you have a check-up with your obstetrician. Baby Immunizations Routine immunisations are done at 6 weeks, 10 weeks and 14 weeks in the first few months of your baby’s life. This is irrespective of whether your baby was born prematurely or at term. The practice will arrange for your baby’s immunization at one of the private baby immunization facilities available in Worcester. Hearing Test It is recommended to have your baby’s hearing tested after birth. The hearing test can be arranged with the following audiologists in Worcester : Elda Van Dijk 082 331 8889 (66 Fairbairn Street) Ula Rabie 023 347 4176 (30 Russell Street) Helmien Van Rooyen 072 179 8486 If you have any further questions or experience any problem not addressed above, be sure to give the practice a call – we will gladly assist you. Office hours 08h00-16h30 023 342 2333 After hours 079 294 3199 1. Have a set bedtime and bedtime routine for your child. 2. Bedtime and wake-up time should be about the same time on school nights and non-school nights. There should not be more than about an hour's difference from one day to another. 3. Make the hour before bed a shared quiet time. Avoid high-energy activities, such as rough play, and stimulating activities, such as watching television or playing computer games, just before going to bed. 4. Don't send your child to bed hungry. A light snack before bed is a good idea. Heavy meals within an hour or two of bedtime may interfere with sleep. 5. Avoid products containing caffeine for at least several hours before bedtime. These include caffeinated fizzy drinks, coffee, tea and chocolate. 6. Make sure your child spends time outside every day whenever possible and is involved in regular exercise. 7. Keep your child's bedroom quiet and dark. A low-level night light is acceptable for children who find completely dark rooms frightening. 8. Keep your child's bedroom at a comfortable temperature during the night (24 degrees Celsius). 9. Don't use your child's bedroom for time-out or punishment. 10. Keep the television set out of your child's bedroom. Children can easily develop the bad habit of "needing" the television to fall asleep. Source: Owens J, Mindell J. Sleep hygiene : Healthy sleep habits for children and adolescents. In: A clinical guide to pediatric sleep, 2nd ed, Lippincott, Williams & Wilkins, Philadelphia 2010. Die volgende hoeveelheid ure slaap per 24-uur siklus (slapies deur die dag ingesluit) word aanbeveel :
0-3 maande : 14-17 ure 4-11 maande : 12-15 ure 1-2 jaar : 11-14 ure 3-5 jaar : 10-13 ure Bron : National Sleep Foundation (VSA), 2016 Your baby's Road To Health Booklet (the red or green one you received home in the maternity ward) contains a schedule only for the essential Expanded Programme on Immunization vaccines, available to each child in South Africa via a public sector immunization facility. There are additional cover available for protection against the following diseases :
When does my baby, infant or toddler have diarrhoea? When there is a significant increase from the usual bowel movement frequency, associated with a change in the character of the bowel movement to a liquid consistency.
Consult a doctor when your baby/infant/toddler has diarrhoea in the presence of any of the following :
Consult a doctor in the case of:
Consult a doctor:
Immediately consult a doctor if :
In the following scenarios, a baby or toddler needs to be seen urgently by a doctor :
Consult your doctor in the presence of any of the following:
Recurrent vomiting Confusion, irritability, change in behaviour or personality A change in vision, double vision, a new-onset squint, a new-onset of slurry speech, loss of balance, unsteadiness, an abnormal walking pattern, weakness of an arm, leg or one side of the face or deterioration in dexterity The occurrence of an epileptic seizure A non-blanching rash Constipation occurs when bowel movements occur less frequently than normal despite a good intake of food and/or if stools are hard, large and/or difficult or painful to pass.Constipation occurs when bowel movements occur less frequently than normal despite a good intake of food and/or if stools are hard, large and/or difficult or painful to pass.
When are bowel movements too few? When there is a significant decrease from the usual bowel movement frequency (for example usually having 1-2 bowel movements per day and then skipping two days despite a good intake of food). Newborn babies pass approximately four soft/liquid stools per day in the first week of life, with breastfed babies passing more in comparison to formula-fed babies. Young infants below three months of age usually pass 2-3 stools per day. The frequency of bowel movements in breastfed babies has a wide range of normality: from having a bowel movement shortly after each feed to having one (large) bowel movement every seven days. An infant with the latter infrequent normal pattern should be distinguished from the infant who is not getting enough : the former shows good weight gain despite the infrequent bowel movements. Formula-fed babies shouldn’t go more than three days without a bowel movement. Toddlers should have 1-2 bowel movements per day, depending on intake. When to consult a doctor when your baby or toddler is constipated:
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