accidental posioning of your baby

SAFETY GUIDELINES As a parent of a newborn, you’re likely to have many concerns about the safety of your baby. This section provides some guidelines on keeping your baby safe.

 POISON SAFETY It’s never too early to poison-proof your home! Children under the age of 5 are at the greatest risk for accidental poisoning. All children are born with a natural curiosity about the environment around them. They explore this environment by putting everything into their mouths. As they begin to crawl, walk, and climb, this curiosity increases and so does the risk for poisoning. Many poisonings occur while a parent is using a product—such as a cleaning solution or paint. The child may start to play with the cleaning bucket or paint can. Don’t be taken by surprise! If a poisoning occurs, remain calm and follow these instructions:
■ Swallowed poison: Call your doctor
■ Poison in the eye: Gently rinse the eye with lukewarm (not hot) water for 15 minutes. Do not force the eyelid open!
 ■ Poison on the skin: Remove contaminated clothing and rinse skin with water for 10 minutes. Wash skin gently with soap and water and rinse thoroughly.
 ■ Inhaled poison: Immediately move into fresh air. Avoid breathing fumes. Open doors and windows wide to allow fresh air into the area. If the victim is not breathing, start CPR and call your doctor

THE LATEST ON THE USE OF IPECAC SYRUP The American Academy of Pediatrics no longer recommends keeping a bottle of ipecac syrup on hand at home. In fact, they recommend that parents throw away existing ipecac syrup

Immunisation for your baby

IMMUNIZATIONS
Immunizations (vaccines) are an important way to protect your baby from life-threatening diseases. Vaccines are among the safest and most effective medicines. Vaccines work best when they are given at certain ages, with some vaccines given over a series of properly spaced doses. They are started at birth and are required before starting school. The following table summarizes the routine early childhood immunization schedule, as of 2004. This schedule is based on recommendations of the American Academy of Pediatrics, the American Academy of Family Physicians, and the Centers for Disease Control.

AGE             VACCINATIONS (# IN SERIES)
Newborn      ■ Hepatitis B (1)
2 months      ■ Hepatitis B (2) ■ DTaP (1) ■ Hib (1) ■ Polio (1) ■ Pneumococcal (1)
4 months      ■ DTaP (2) ■ Hib (2) ■ Polio (2) ■ Pneumococcal (2)
6 months      ■ Hepatitis B (3) ■ DTaP (3) ■ Hib (3) ■ Polio (3) ■ Pneumococcal (3)
12-18 months ■ DTaP (4) ■ Hib (4) ■ Pneumococcal (4) ■ MMR (1) ■ Varicella (1)
2-4 years        ■ Hepatitis A (1)
4-6 years        ■ DTaP (5) ■ Polio (4) ■ MMR (2) ■ Hepatitis A (2)

DTaP = Diptheria, Tetanus, and Pertussis
Hib = Haemophilus influenzae type b
MMR = Measles, Mumps, Rubella

New born screening

NEWBORN SCREENING TESTS Your baby is screened for several problems before going home— including high bilirubin, hearing impairment, and hereditary diseases.

BILIRUBIN SCREENING Every newborn is screened for high bilirubin (hyperbilirubinemia) before leaving the hospital. High bilirubin causes jaundice (described on page 22). If your baby’s test result shows that your baby is at risk, you’ll be instructed to take your baby to your doctor’s office or to the hospital or an outpatient lab to repeat the test a day or two after your baby goes home. It’s very important that you have this follow-up test as instructed

HEARING SCREENING Good hearing is essential for the normal development of language and listening skills, yet 1 in 300 newborns have some sort of hearing problem. Too often, hearing loss is not detected in until a speech or language delay has already occurred. That’s why the American Academy of Pediatrics recommends that all newborns have a hearing screening before they leave the hospital.

SCREENING TESTS FOR HEREDITARY DISEASES Most states require that newborns be tested for certain hereditary diseases. The problems caused by these disorders can usually be prevented if treatment is started early enough. Testing requires taking a few drops of blood from your baby’s heel. Usually, two tests are necessary: The first test is done shortly before your baby goes home from the hospital. A follow-up test may be required sometime between 7 and 28 days of age , and between 5 and 15 days . If a second test is necessary, you’ll be given a screening kit and instructions for when to follow up with your doctor. Make sure you take your screening kit with you to your follow-up appointment.

Disorder                                   Description           -               How treated
Phenylketonuria (PKU)        A hereditary disease in which the body can’t break down certain parts of    1 in 10,000 newborns    proteins (phenylalanine amino acids). Can lead to mental retardation.                                                                                                     Special diet
Hypothyroidism                  A hereditary condition in which the thyroid gland doesn’t produce              1 in 5,000 newborns           enough of a substance called thyroxine. May cause mental retardation and                                             slow growth. Thyroid replacement medicine (thyroxine)
 Galactosemia                    A rare hereditary condition in which the body can’t break down galactose  1 in 50,000 newborns        (a type of sugar), which is found mostly in dairy products. May lead to                                                   mental retardation, cataracts, and liver damage. Special diet By request* Hemoglobinopathies,       Abnormalities in the hemoglobin of red blood cells. May lead to anemia    including sickle cell anemia             and bleeding problems. Early education and clinical care\
1 in 3,000 newborns   

Thrush baby

THRUSH AND OTHER YEAST INFECTIONS Thrush is a yeast infection in your baby’s mouth. It may appear as white or grayish-white, slightly elevated patches resembling curds of milk on the tongue, roof of the mouth, lips, or throat. These patches cling and will not wipe or rinse off easily. If they are wiped off, they leave the underlying tissue raw and may make it bleed. Other symptoms of thrush may include irritability, poor eating, and a persistent diaper rash. Diaper rash caused by a yeast infection may have red spots along the edges. If you think your baby has thrush or a yeast infection, contact his doctor. If you are breastfeeding and your baby develops thrush, you may also have a yeast infection on your breasts, which can cause your nipples to crack, itch, or burn. Nipples may also become red, swollen, and painful. For information on treating yeast infections—for your baby or yourself—refer to IHC’s Guide to Breastfeeding booklet. If you have a vaginal yeast infection, you need to be sure to thoroughly wash your hands so you don’t pass it on to your baby. Thrush and other yeast infections are treated with medication and/or ointment. Many times, both you and your baby must be treated at the same time.

CHANGE IN BEHAVIOR (IRRITABILITY OR LETHARGY) Every baby has his own temperament and personality. Some babies are calm and placid, while others are fussy. Most babies are very sleepy for a couple of days after birth. You will quickly discover your baby’s unique temperament. Changes in your baby’s temperament or energy level may signal problems. Look to the guidelines at the right to help you decide when to call the doctor or get emergency care.

RAPID OR SLOW BREATHING A newborn’s breathing pattern tends to be more rapid and irregular than an adult’s breathing. However, if your baby takes more than 60 breaths per minute, call your baby’s doctor. If your baby’s chest sinks in during breathing, or if your baby appears to have trouble breathing, seek emergency care. 

Yellow baby

JAUNDICE Jaundice is the yellowish coloring of the skin and eyes that is sometimes seen in newborns. Jaundice is caused by hyperbilirubinemia—a condition in which a substance called bilirubin builds up in the bloodstream and is deposited in the skin. Your baby is tested for high bilirubin before leaving the hospital. A little jaundice is common in newborns for the first 3 to 5 days. The yellow color of jaundice starts at the head and gradually moves downward on the baby. As the baby’s liver breaks down bilirubin, the jaundice gradually disappears. However, in up to 5-6% of babies, bilirubin levels are high enough to require treatment. Treatment includes phototherapy (fluorescent light treatment) and frequent feedings of breast milk or formula. In most cases, treatment can be done at home, but sometimes hospitalization is required. If your baby’s bilirubin level is above normal in the hospital—but not high enough to require treatment—your doctor may schedule you for a follow-up bilirubin test. It’s very important to have this testing done. If high bilirubin levels are not treated, some babies may suffer neurological (brain) damage. That’s why it’s also important to notify your baby’s doctor if you notice your baby becoming more yellow, or if the jaundice covers more of the body than when you were in the hospital. You should also notify your baby’s doctor if your baby becomes lethargic, is eating poorly, has an unstable temperature, or has behavior changes—these can all be signs of a high bilirubin level. Prompt treatment is important to prevent permanent injury in a newborn.