Category Archives: Baby

No Need To Fear Vaccines

What a terrible injustice to vaccine makers, and to doctors and nurses who give vaccines. The injustice was that of Wakefield  and his associates when they published a report in 1998 that  linked MMR vaccines with autism. That created a worldwide  furor (yes worldwide through internet scuttlebutt) over the MMR  vaccine and autism. Why do I call it an injustice?

The little told story of this incendiary conclusion of Wakefield  and friends is that their conclusion was false. In 2006,  seven out of ten investigators retracted their support for  Wakefield’s conclusions. Furthermore it was revealed that  Wakefield was funded by lawyers who brought cases against  vaccine companies. This fact has lead Wakefield to court to  defend his falsification of his data. So in fact, there has  never been a verifiable research study supporting an autism-vaccine link. Yet, the rumors and bad mouthing of vaccines  continue.  Many medical groups from different countries have  looked at vaccine data and have concluded just the opposite –  that there is no link between vaccines and autism. There is no  link between MMR vaccine and autism and there is no link between  mercury in vaccines and autism. So why do people still fear  vaccines?

It is easy for a family with an autistic child to conclude that  the autism diagnoses coincided with the end of the primary  vaccine series. That is a coincidence of timing – but not cause  and effect. Yet this makes it easy to perpetuate the vaccine  fear that vaccines cause autism. They do not. There is no  reason to fear vaccines. In fact, there is good reason to fear  not being vaccinated.

In my twenty-five year career in pediatrics I have seen cases  of measles, mumps, meningitis, chicken pox and polio – all  preventable through vaccines. We see dramatically less of these  harmful illnesses through the vaccines we give. Pediatricians  use to do spinal taps weekly on babies looking for meningitis.  Now spinal taps are a rare medical procedure in pediatrics.   Some people think that we don’t need to give these vaccines  as often since these diseases are more rare. Nothing can be  further from the truth. Last year, measles and mumps swept  across part of our country from the Midwest to the Northeast.  Other bacteria that cause ear infections, pneumonias, and  meningitis are still alive and well. Whooping cough still  troubles communities. Even polio is not eliminated worldwide.  The risks of vaccines are minimal compared to one death caused  by one of these nasty illnesses.

If you are worried about vaccines, you need not be.   Nonetheless, talk to your doctor. Bring this article to him  or her. See if your doctor can verify the truths in this  article. The fact of the matter is this, the worldwide rumor  mongering about vaccines has been a great force to battle. We,  in medicine, have not been very good at battling the vaccine  naysayers. But the evidence is clear and more confident  conversations about the great benefits of vaccines have to  occur. In reality, there is little fear. Vaccines save  lives and your child is safer in this world when he or she is  vaccinated.

Navigating Through The Baby Information Ocean

Congratulations! You are going to have a baby. As you  get close to the time of having your child, after going  through nine months of pregnancy you face a new life and a  new world of information. The amount of baby information  is astounding. Just trying to buy the appropriate car seat  may require hundreds of pages of reading. The American  Academy of Pediatrics car seat pamphlet alone is six  pages long! Then there are thousands of newborn books,  magazines, websites, videos and tapes on all the other  aspects of care. By the end of your baby’s first month,  you can find yourself afloat on a virtual ocean of baby  information.

As a Pediatrician who for twenty-two years has enjoyed  counseling new parents, I have a set of guidelines to help  keep you from being overwhelmed by all the baby information  that surrounds us. Here is a guide for new parents to use  to go from novice to good parent.

1. There is not one expert that you must listen to.  Even when I advise parents in my practice, I tell  them that what I offer is only advice. Advice can  be used or discarded depending on how it suits you.  With your baby you are the parent and only you will  become the expert on your baby.

2. There is nothing more valuable than a few good  friends. Your friends who have seen through  child rearing may have valuable things to offer to  you. Support from a trusted source such as your  mother or an intimate friend, is as time tested as  pregnancy itself. Unfortunately with our mobile  society, this part of child rearing has become harder  to maintain. Nevertheless, finding the right people  to support you can be critical to your success  especially in the early days of your parenting  career.

3. Trust yourself. Though you will need support as a  new parent, you also need to have faith in yourself.  Most of baby care is using common sense. And I must  say that through all my experience I have mostly  witnessed good use of sense from parents. We all  have to grow into our parenting roles. This takes  time. None of us have parented before and none of us  go through a training program. This gives us plenty  of room for self doubt. But have faith. Many people  have gone before us and learned on the job as we  will. You will do well. Take your time. This is an  overwhelming experience with an overwhelming amount  to learn. Stay committed to learning and you will be  a great parent.

4. Take in a little at a time. We already established  that there is a huge amount of baby care and child  rearing information. But nobody uses all that  information all the time. Having resources at your  disposal when you need it may be a more functional  approach to the information. Have your friends or  your pediatrician suggest some books to have at your  disposal. A few key books, a good local library, and  perhaps a parenting magazine subscription (a good  baby shower gift) may be all you need. Magazines  are good to keep since you’ll never know when that  back issue will be just the answer for the current  problem you’re having with your child. Getting the  information when you need it is practical and less  stressful than trying to know everything there is to  know about babies all at one time.

5. Choose what works for you. When you are facing a  problem with your child you will face a time when  your pediatrician says one thing, your mother another  and your favorite magazine a third. No two people  raise their babies the same way. Likewise, nobody  always has the exact advice you need for your baby.  You are allowed to make a decision for yourself on  what to do with your baby. There is no right or  wrong way to raise a child. Do what your heart says  is right. You have to be the one comfortable with  your own parenting.

6. Finally, the most important thing is to love your  child. Sometimes we can be so worried about whether  we are doing things right that we forget the most  important things. No decision we make will break  our baby’s childhood. Relax. Smile, play with your  baby. With enough support and resources available  we should feel empowered to feel good about being a  parent. We should relieve ourselves of the pressure  we feel. And recognize that the most important  parenting rule is that our children should feel loved  and cared for. So love your child and everything  will be ok. You’ll feel like you are surfing above  that information ocean.

In Their Faces

A one month old looks passively around the exam room and finally meets my eyes. He stops and stares with wonder.  He found something he enjoys looking at – an oval face.

A two month old takes a shorter time to search the room and  find my face. He doesn’t just stare, he smiles and coos –  as if he has things in his head to say but doesn’t know how  to get the words out.

A four month old looks right at me and smiles and coos.  Sometimes he screeches out loud to get my attention. He  doesn’t want me to talk to his mother he wants my total  attention.

At six months of age, a baby looks at me with a frown at  first. He tries to judge my emotion. If I turn to him and  frown, I could make him cry. But I never do that. I know  what he is looking for. As I go over to the exam table I  smile widely. My little friend responds with a beaming  smile and a gurgle.

It gets harder at nine months because at that age they  don’t like any smiling faces, they prefer the faces they  know and love – mom and dads. But that’s okay with me  because as they cry in response to me in the office at  nine months of age, I take comfort in knowing they are  developing well.

I am so lucky to have a job where every week I get to  experience babies. I love to see the changes in their  responses to me as they develop.

Watching children develop is such a joy. I never tire of  seeing it happen. It is something we should all enjoy and  take interest in.

The development in children in the first five years is  absolutely fascinating. They start with responding to  faces with smiles and coos. They progress to knowing their  parent’s faces and preferring those faces to others. They  start learning words in order to interact better. They  fear strangers yet act like the world is theirs to explore  When not getting their way with the world, they start  having temper fits. But as language and understanding  improve the fits go away and sharing begins. Through  sharing and interaction more words and language come. And  when learning more about that language a fascinating world  of the alphabet, letters and labels becomes awakened.  Before we know it, our child is ready for kindergarten.

The first years of our children’s lives are precious  because of this amazing development that occurs. Ninety  percent of their brain development occurs in those first  five years. But they cannot develop alone. This is why  we need to pay attention to our children. They need us  because they can only develop in these vital years through  interaction with us. We need to remember to turn off the  distractions – the TV’s, the movies, the computers – and  stay in our babies’ faces. By being “in their faces” they  develop the skills they need to interact. And by being  in our children’s faces we get to witness it all unfold.  Parents shouldn’t forget this lesson just because our kids  get older. Almost at any age our children can learn from  us. In order to do that they need to interact with us.  This is what family time should be all about – interacting  and watching them grow before our eyes.

Good News About Vaccines

For the past several years I have found myself on the defensive over a very fundamental treatment I provide as a pediatrician. I have been giving children vaccines according to the American Academy of Pediatrics guidelines for 22 years. But in recent years there has been a backlash against the very vaccines we use to prevent known serious illnesses. As a response to this backlash I built a file of articles that supported the use and defended against supposed side effects of the vaccines. In recent days there has been great news about vaccines to add to my file. The news is they are safe and do not cause autism.

In the late nineties two events stoked the fires of skepticism about vaccines. First, in 1998, a well known British medical journal, the Lancet, published a report based on work of thirteen prominent physicians stating that the MMR vaccine was associated with autism. A storm of controversy over the use of the MMR vaccine followed. The second event in the late nineties that caused a furor was the removal of thimerosal from vaccines. Thimerosal, a preservative used in vaccines, contains mercury. It has never been shown to be a health hazard. However, because of the potential for buildup of mercury in the body, it was prudent to remove thimerosal from vaccines. This was done on a voluntary basis by the manufacturers. Just that move caused speculation that vaccine manufacturers were hiding something. Further speculation followed that thimerosal was associated with autism – with no medical evidence proving it.

Through the early part of this decade, scientists and lay people have battled on both sides of the argument. Advocates for parents of autistic children questioned the MMR and thimerosal link while doctors and researchers tried to study the association. Now, within the past two months two news reports help clarify the reality.

First, in April, ten of the original thirteen investigators who published the link between the MMR vaccine and autism retracted their conclusions. It was revealed that the study, which was funded by lawyers who focus on vaccine damage cases, was markedly flawed. The original study that served as a basis for legal cases involving the MMR vaccine around the globe was biased. The lead investigators in the study are currently under legal investigation for conflict of interest.

A second story about vaccines came out in May 04. The Institute of Medicine released a report by its thirteen member panel saying that there was “little credible evidence that thimerosal was associated with autism“. Autism is a complex and difficult problem for parents and children. I know many autistic children and their families. There is still no clear explanation for autism. I wish there was. But at least we can learn some lessons from these two reports.

These two reports are of great value to physicians who promote vaccines for kids. The first report about the authors of the Lancet article takes the wind out of the sails of the MMR – autism relationship. It had been viewed with skepticism and was never supported by other research. But now to have the original authors retract their opinions makes the original article meaningless. Coupled with research disproving the MMR autism association we can now put this speculation to rest.

The thimerosal argument was piggybacked onto the MMR argument for those who wanted to link vaccines to autism. But with “no credible evidence” for such a link we can now be doubly reassured that vaccines have no connection with autism.

The general public never sees the illnesses we seek to prevent with vaccines. The illnesses are awful and often deadly. It is one of the miracles of medicine that we have vaccines for our children. Due to vaccines far fewer children need respirators, spinal taps, intravenous medicines, hospitalizations, ER visits, and intensive care unit treatments. We see far fewer cases of meningitis than we saw even 10 years ago. And in our lifetime – we will see polio eliminated worldwide because of vaccines.

So when I give immunizations to children these days, because of the recent news, I give them with renewed confidence that they are the most valuable preventative care treatments I give to children. I feel so lucky to have them. Now, I just hope more people can be reassured about their safety.

Dealing With The Crying Baby

I remember the experience as if it was yesterday. I remember having my son in my arms and trying everything to soothe him. I had my magical answers and my wife had hers. Sometimes a bouncy walk with him on my shoulder would work. Sometimes my wife would use a rocking chair and have him across her lap. And many times we would just keep switching off trying new tricks until he finally tired himself out. This was almost seventeen years ago when my wife and I had a very fussy, colicky baby. It was then that I learned how stressful a crying baby can be. The experience has stayed with me and has given me extreme sympathy to parents of crying babies. It also gave me a professional curiosity about what causes some babies to be such tenacious criers.

During the time of my son’s colic I read many theories on “crybabies”. Most people believe that the crying has to do with gas, diet and their abdominal distension. Others believe it is due to over stimulation and fatigue and the crying itself makes children “gassy”. Still others believed that it was due to an inability to ease into sleep – an ability that becomes easier with some brain maturity. All these theories have some merit. But none of them provide the answer to every crying baby.

Much of the advice that people give about handling crying infants stem from these theories. Many mothers are told to change the baby’s diet in one way or another. This goes along with the theory that the formula or breast milk is causing the baby to be gassy and the gas is causing the discomfort. Others receive advice to put their baby down since the constant contact with the parents is contributing to “spoiling” or “over stimulating” the baby. Most of this kind of advice comes from beliefs without truths behind the beliefs.

So what do we really know about crying babies. We know that babies cry 2­6 hours total in a day and that some are worse than others. About 10% of babies cry more than other babies (probably at the 6 hour end of the range). All babies cry more at six weeks of age than in the first few weeks but then settle down again by three to four months of age. A few babies will have their fussiness decrease with diet changes. Most will not. All babies have gas. Only some seem to be bothered by the gas. And all babies strain when having bowel movements.

So with this information how should families handle a crying infant?

  1. Recognize that it is a phase and no matter what you do your baby will be calmer by three to four months of age.
  2. Take everyone’s advice but see what works for you.
  3. The crying baby is a natural phenomenon and is no one’s fault.
  4. You may want to try a formula change if you are bottle feeding or a change in your diet (i.e. stop milk products) if you are breast feeding.
  5. Baby experts recommend spoiling of all babies for at least three months. Before that age it is too young to let your baby cry for long by themselves. Short periods alone are okay.
  6. It is okay to take a break from a fussy crying baby. Get some tea, go for a walk or take a shower. Taking care of a crying baby is stressful and parents do need to get breaks.
  7. The more hands around to hold a baby the better. It is good to have people to help you care for a crying baby. It is definitely worthwhile having support for this difficult problem.
  8. Cry babies do become happy babies over time. Support your baby through this time. Support their gassy bellies. Provide them warmth. Rock and swaddle them. And rest assured the baby you have been waiting for will come to you with plenty of smiles – by four months of age.
  9. If you have any doubts about your child’s health in the midst of all the crying, by all means, see your pediatrician. Pediatricians are familiar with fussy babies and can help families be assured that their child is just colicky and isn’t sick.
  10. Remember, that just because you have a crybaby, it doesn’t mean you are a bad parent. And it doesn’t mean you don’t know what you are doing. Nobody knows exactly why we have colicky babies. But one thing is for sure; they are a natural phenomenon and exist in many cultures and economic levels. Crybabies just happen. But with time and your support they can get through this rough start to their new life.