newborn_babies_06-14-12

newborn

babies a guide to healthy babies

baby’s First test

What you need to know

sleepy baby

the 1st year

What to look for

BaBy’s First shots

Take Care of Yourself

Postpartum Depression

Help with

breastfeeding a special advertising supplement to the Reno News & Review www.health.nv.gov

2 TexT4baby / by Alexandra E. King 3 Take a seaT / by Bridget Meade

contents

3 healThy home 4 yoUR GUide To bReasTfeedinG sUCCess / by Kate Thomas 5 healThy families 6 PRoTeCTion sTaRTs wiTh The fiRsT shoT / by Paige Gore 8 sCReen TesT / by Bridget Meade 9 baby’s fiRsT TesT 10 newboRn heaRinG sCReeninG / by Alexandra E. King 11 a family’s JoURney wiTh heaRinG loss / by Bridget Meade 12 sleeP like a baby / by Alexandra E. King 13 The PeRiod of PURPle CRyinG 13 safe haVen 14 TakinG CaRe of mommy / by Kate Thomas 15 yoUR Child aT yeaR 1 16 ResoURCes

text4baby An exciting new way to get important information to support a child’s healthy development b y

A l e x A n d r A

e .

K i n g

Did you just find out that you’re pregnant? Are you concerned about your infant’s nutrition? Want quick tips to help you have a healthy pregnancy and healthy first year for your baby? Expectant or new moms can easily get the information they need through a free service on their cell phones: text4baby.

Launched in February 2010, text4baby is a national service that delivers important information to mothers concerning their pregnancies and the first year of their baby’s life. This service sends information about pregnancy and newborn babies as accurate and friendly text messages covering topics such as immunizations, mental health, car seats, breastfeeding, oral health, baby check-ups, safety, developmental milestones and nutrition.

REGISTER Text4baby is free and women can register at text4baby.org or by texting BABY (or BEBE for Spanish) to the number 511411.

Those signed up for the service receive free timely messages with tips about pregnancy and caring for your baby.

When registering, users will be asked to provide their zip code and their baby’s due date or birth date. Text4baby uses this information to deliver messages that are useful at the appropriate times. Information in the texts have been developed by physicians, nurses and national medical organizations to provide the best information.

2

NEWBORN BABIES

Expecting moms will receive SMS text messages with information timed to the due date of their baby.

NO COST Text4baby is available to anyone with a cell phone that is set up for text messaging. Pre-paid cell phones and pay-as-you-go cell phones can also access the text4baby information service as long as they are subscribed to one of the text4baby mobile operating partners. A list of mobile operating partners can be found at text4baby.org under “partners.” Text4baby is able to provide free text messages to anyone with participating carriers even if their plan does not include text messaging. Additionally, text4baby will not take away from plans with limited texts per month.

NO ADS; OPTING OUT IS EASY Text4baby is user-friendly and does not send advertisements or share participant information with anyone. Any time a user wants to stop the service, they text the word “STOP” to 511411.

a special advertising supplement to the Reno News & Review / www.health.nv.gov

Text4baby is an exciting and innovative way for millions of pregnant women and new moms across the country to get the most important information they need to support their child’s healthy development.

If you’re an expectant or new mom or you know one and want to learn more, go to www.text4baby.org.

the area and a certified technician provides a free car seat inspection. The wait time is usually less than 30 minutes.

For those who cannot attend a checkpoint, the Northern Nevada Fitting Station can help. Call (775) 815-0981 for an appointment.

Take a Seat

A car seat is one of the most effective ways to protect your child.

B y

B r I d G E T

What are the most current car seat recommendations?

• Children should stay in a rear-racing car seat until their second birthday or until the rear-facing weight limit is reached. The rear-facing weight limit varies based on the seat.

M E A d E

As an expecting parent, purchasing a car set can be overwhelming. Vickie Fisher, program coordinator for REMSA’s Point of Impact program provides tips for parents:

• The child should continue using a five-point harness until

What is the law in Nevada?

• Children under the age of 13 should ride in the backseat.

Nevada state law states that all children under 6 years and/ or 60 lbs must be in an approved child restraint system.

(NRS 484B.157) However, Nevada law doesn’t change very often and the law does not reflect the most current recommendations.

• Children need to stay in a booster seat until they are 4

Can I leave the hospital without a car seat?

Hospital policy requires parents to leave with a car seat.

I can’t afford a car seat. What do I do?

REMSA provides car seats free of charge through their Point of Impact Check Program or through the Northern Nevada Fitting Station, to families who qualify.

In stores I have noticed shoulder strap covers to make my baby more comfortable. Is it OK to use them?

The Federal Government does not issue any regulations applicable to these products and they are not subject to any mandatory crash testing. Anything that comes with the seat has been crash tested. We recommend limiting use of these types of products only to those that come with the seat.

the child reaches the weight or height limit of the seat.

If the vehicle does not have a backseat, then make sure all airbags are turned off.

I found a great deal on a used car seat on Craigslist.

Should I buy it?

REMSA does not recommend used car seats. Used car seats can be extremely dangerous to a child if the history of the car seat is unknown. Most car seats are a one-child use only.

A car seat is no longer considered safe if any one of the following occurs in a crash: an airbag inflates; the door near the car seat is damaged; injuries were sustained, or the car could not be driven from the scene.

What are some tips for properly installing a car seat?

Make sure you follow all installation instructions. When installed, the car seat should move less than one inch along the belt path. The child should also be securely harnessed in the seat. Three out of four car seats are installed incorrectly, so if one has questions, it is best to seek help.

I’m not sure my car seat is installed correctly.

Where do I go for help?

8

REMSA’s Point of Impact Program provides a monthly checkpoint program. They set up at various locations across

What is the seat belt fit test?

• The child must be able to sit all the way back in the seat with legs bent over the seat.

• The child’s feet must touch the floor.

• The lap belt fits across the hips and the shoulder belt across the shoulder.

• The child must be able to remain like that for the entire ride.

REMSA’s Fitting Station takes car seat inspection appointments Monday through Friday for a fee. The cost is $25 for the first installation, $10 for each additional installation. The rates are on a sliding scale for the families who qualify. Spanish speaking technicians are only available on Fridays.

For more information, call (775) 828-7500.

HEAltHy HOmE PRINCIPlES fOR yOuR BABy’S SAfEty The “8 Principles of a Healthy Home” approach aims to address problems in the home before they become a serious health concern for your family.

1 DRY

Moisture in the home can lead to mold and mildew, and can support pests.

Too much moisture can also damage the home itself. Keeping your home dry helps you avoid these problems, and helps you create and maintain a healthy home.

2 CLEAN

Because many health hazards are related to clutter or filth, a home should be kept clean. Clutter can collect dirt, provide a hiding spot for pests, and can cause trips or falls.

3 FRESH

feet 9 inches, between the ages of 8 and 12, or until they meet the seat belt fit test.

A home should have clean, fresh air. Indoor air can become polluted if it is not properly circulated and filtered. Bringing fresh air in and filtering out pollutants helps keep your family healthy.

4 PEST-FREE

Cockroaches, rodents, and other pests come into the home looking for food, water, and shelter. Unfortunately, these pests bring diseases and hazards with them. The good news is that pests can be eliminated using safe techniques that will not harm your family or pets.

5 SAFE

A home should be safe for residents of all ages. Injuries can occur from a variety of objects and sources, and contribute to drowning, suffocation, and poisoning. Most of these injuries can be easily prevented with just a few simple steps.

6 CONTAMINANT-FREE

Contaminants such as tobacco smoke, asthma triggers, and common household products can be harmful to your health. Household cleaners and pesti-

cides must be properly stored to prevent poisoning and other injury.

Keeping your home contaminant-free is important to creating a healthy environment for you and your family.

7 MAINTAINED

All homes, no matter how old or new, need to be maintained. Cracks, leaks, and breaks can lead to a variety of problems in your home. Taking care of minor repairs right away often saves time, effort, and money, and can help prevent health problems. It can also help prevent large repairs later.

protected from outside weather (especially hot and cold air) and (2) that you make small changes in your home that help you conserve water and energy.

“Green” homes can save you money on utility bills, can help conserve the Earth’s resources, and can positively affect your family’s health.

For more information on the Nevada Healthy Homes visit www.health.nv.gov/healthyhomes.htm

8 GREEN

Keeping your home “green” is an important step in making your home healthy.

Keeping your home “green” usually means two things: (1) that your home is

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NEWBORN BABIES

3

Your Guide to Breastfeeding Success A lactation consultant answers your questions b y

K at e t h o m a s

Robin Hollen, R.N., I.B.C.L.C, has been a board-certified lactation consultant for more than 20 years. She is a lactation consultant at Renown Regional Medical Center, the sole proprietor of Starfish Lactation and is cochair of the Northern Nevada Breastfeeding Coalition (NBFC), a partnership with the Maternal Child Health Coalition. Hollen, mother of three boys and one girl, spoke to us about breastfeeding benefits, complications, and where new moms can find support in the Reno area.

Why breastfeed?

Medical entities worldwide recommend breastfeeding because of the health benefits for the babies and moms, such as breast cancer prevention. Nonetheless, it is a choice. Like any recommendation—we should exercise, we should eat certain foods—it is a recommendation, and women make their own personal choice. Over 80 percent of women breastfeed, some longer than others.

The interest in breastfeeding exists because women are aware pf the benefits and want those benefits for themselves and their baby.

Is it hard to start breastfeeding?

It depends on who you ask. Sometimes getting started goes very smoothly and sometimes not. Approximately 80% of women who want to breastfeed, have never seen anyone breastfeed so it may not feel like the obvious choice. Hospitals in the United States, and I would say especially locally in Reno, encourage moms to do what we call “skin to skin” holding their babies on their chest, which is conducive to breastfeeding.

What are some common problems moms have when breastfeeding?

A common problem is that the baby does not latch on correctly. Latching on refers to how the baby’s mouth grasps the nipple. Improper latch often results in sore nipples. Another situation is that the baby does not gain enough weight, possibly indicating the baby is not getting enough milk. In most cases, poor latch is the case.

4

NEWBORN BABIES

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MOM says “I think breastfeeding is the most wonderful thing for mom and baby. The health benefits are a given.

Then there’s the bonding with my child. I feel I’m adding something extra by me feeding my baby.”

Gladys Cook • Carson City, Nevada What do I do if I have a poor latch with Where can I get support in Reno? my baby?

Renown has a support group, Forum, and it is a place Ask for help in the hospital. My rule of thumb is if it hurts, something is not right. Breastfeeding does not hurt. For solutions, try different positions and if you find something that works, stick with it. There are treatments for sore nipples, but if you don’t address the cause it is like putting on a Band-Aid. Moms suspecting poor latch and sore nipples should seek help with this right away. This is where your partner can be a great help.

They can go out and find the help.

It is best to begin breastfeeding as soon as possible and avoid pacifiers or artificial nipples.

How often will I need to breastfeed?

The standard answer is eight-to-12 times a day in the beginning to establish breastfeeding. This will both feed the baby and encourage the body to make more milk. If a mom has the glandular capacity to produce 4 or 5 ounces rather quickly, their baby won’t need to breastfeed as often as a baby whose mom makes 2 to 3 ounces at a time.

Those babies may nurse every two to three hours or maybe more at night. Babies eat when they are hungry.

How long should a mom breastfeed?

The American Academy of Pediatrics recommends breastfeeding for the first year of life then for as long as mom desires. The World Health Organization recommends two years and then as long as mom would like.

Moms choose what works for their lives.

for moms to come together and share information. They meet on Thursday at 11 a.m. My practice, called Starfish Lactation, has a group that meets Tuesdays at 4pm. Both Renown and Starfish have a scale for weighing babies in grams so we know exactly how much weight the baby is gaining. Watching nursing babies flourish by gaining weight can be very encouraging for moms and builds their confidence. St. Mary’s has a group for new moms, not exclusively about breastfeeding, but they have a scale. Women, Infants and Children (WIC) has an office at Washoe County Health District and at St. Mary’s. The one at St. Mary’s has peer counselors that are specifically assigned to follow the moms on the WIC program. They do a phenomenal job of peer-to-peer support.

NEvAdA LAW ON BREAStfEEdINg IN PuBLIc, NRS 201.232: Notwithstanding any other provision of law, a mother may breastfeed her child in any public or private location where the mother is otherwise authorized to be, irrespective of whether the nipple of the mother’s breast is uncovered during or incidental to the breastfeeding.

Healthy Families Nevada’s WIC program helps ensure families receive nutritious foods The Women, Infants and Children (WIC) program provides nutrition tips, resource referrals, breastfeeding support and healthy foods. Without fundamental nutrients in fruits, vegetables, and protein sources, children can experience developmental delays and adverse health effects.

To be eligible for WIC, you must be a pregnant, recently pregnant or breastfeeding woman, infant or child up to the age of five (5), have a moderately low income or be receiving Temporary Assistance for Needy Families (TANF), Medicaid, or Supplemental Nutrition Assistance Program (SNAP).

In addition to determining financial eligibility, WIC staff conducts an assessment to determine if the family is at “nutritional risk.” Nutritional risk may result from medical or dietary conditions such as, but not limited to, low iron, being under or overweight, or have a history of poor pregnancy outcomes.

When a family qualifies for WIC, they are given a WIC Electronic Benefits Transfer (EBT) card to shop at one of the 218 WIC authorized grocery stores in the state of Nevada.

Families can purchase their healthy foods from their WIC approved shopping list. Some approved foods include; fresh, frozen and canned vegetables or fruits, whole grains, milk and cereal.

For more information contact Nevada State WIC at (800)863-8942 or www.health.nv.gov/WIC.htm.

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NEWBORN BABIES

5

Protection starts with

b y

Pa i g e

the first shot

g o r e

Protecting their children is the highest priority in parents’ lives. It’s a responsibility that involves daily attention to their childrens’ wellness and safety.

Vaccinations have greatly reduced the risk of children and infants contracting harmful diseases. Yet when parents ignore the facts and immunization rates decline, these diseases return, as we have recently seen with outbreaks of measles and whooping cough in the United States. A newsletter sent out by the American Academy of Pediatrics in April 2012 explained that the surge of measles cases in the United States was due to children and teens who had not been vaccinated.

The Centers for Disease Control and Prevention (CDC) defines immunization as the process by which a person or animal becomes protected against a disease. Protection can result from actually experiencing a disease, or by being immunized with a vaccine.

Parents who want their children safe and healthy must get them immunized The CDC explains that newborn babies are immune to certain diseases because they receive antibodies from their mothers. However, this immunity does not last beyond the first year of life, after which it is possible for a child to become infected by a disease. Don’t wait! It is important to vaccinate your child on schedule to ensure your child’s chance to build a healthy immune system.

Vaccines protect your child and they also impact the health of others in the community. Some children cannot receive vaccines due to age, illness or reactions to the vaccines. By immunizing your child, you are doing your part to prevent disease. When the majority of people are vaccinated this creates herd immunity making it harder for a disease to spread.

Vaccine-preventable diseases can have dangerous, even deadly consequences. Vaccine-preventable diseases can cause hospitalization, seizures, brain damage, blood infections, deafness, paralysis, loss of limbs, meningitis, pneumonia, organ failure, and even death.

Vaccinations save money each year in the United States by vaccinating kids less than one year of age: • Society saves $43.4 billion • Healthcare costs are reduced by $9.9 billion • 33,000 lives are saved • 14 million cases of disease are prevented

Are vaccines safe?

Yes. In order for a vaccine to be licensed it must be tested for safety. Vaccines are studied in thousands of children before they can be licensed. Additionally, the federal government continues to monitor vaccines for safety. Any hint of an issue with a vaccine is immediately investigated by the CDC and the U.S. Food and Drug Administration (FDA). If needed, a vaccine will immediately be removed from the market.

Do vaccines cause autism?

No. Several studies have been conducted to debunk this myth. This myth started in 1998, when a “study” of only eight children had found that the measles, mumps, rubella (MMR) vaccine was causing autism. But the lead doctor on this study had faked the results. This doctor later lost his medical license. Unfortunately, the myth continues. Additionally, children receive most of their vaccinations by 18 – 24 months of age. Because the behaviors of autism tend to appear around this age, parents think that vaccinations were the cause of their child’s autism. Currently no one knows what causes autism.

Are the ingredients in vaccines safe?

Yes. Most parents are concerned about ingredients such as aluminum, formaldehyde, and mercury. Every ingredient has a purpose to improve potency and prevent contamination. Trace amounts of aluminum are in vaccines to enhance the immune system’s response to the vaccine.

People consume more aluminum in the air they breathe, water they drink, and food they eat than what is ever in vaccines. Formaldehyde is used to weaken viruses in vaccines. Because formaldehyde is associated with dead bodies, people think it’s bad. People come into contact with formaldehyde everyday with new clothes, furniture, carpet, and more. Typically the amount of formaldehyde found in people’s blood is 10 times greater than the amount in vaccines. Mercury (also known as thimerosal) is used to prevent contamination of vaccines. Due to public concern, in 2001 mercury was taken out of all U.S. vaccines except for the influenza vaccine. However a mercury free version is available. Even though mercury was removed, this ingredient was never determined to be harmful. Today, breastfed infants ingest 15 times more mercury in breast milk than what is in the influenza vaccine.

Can I skip or delay vaccinations?

You can, but it’s not a good idea. The longer your child is not vaccinated the more susceptible they are to contracting a disease. The immunization schedule is based upon science whereas alternative schedules have no science behind them.

Some parents are worried about having their child get too many vaccinations at the same time because it might overwhelm their immune system. Everyday our bodies are exposed to millions of viruses and bacteria in the food we eat, water we drink, and air we breathe. Children getting more than one vaccine in a office visit is completely safe.

This publication was supported by the Nevada State Immunization Program Grant Number 5H23IP922549-10 from the Centers for Disease Control and Prevention (CDC).

Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.

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NEWBORN BABIES

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If your child is too young to be vaccinated, the way to protect them is to “cocoon” them. Cocooning, as defined by the Global Pertussis Initiative of 2011, is the vaccination of family members and close contacts of a newborn.

Two deadly diseases to cocoon your baby from are pertussis (whooping cough) and influenza. This means anyone coming in contact with a newborn to a 12-month-old, should be vaccinated against these diseases.

In Nevada, 18 hospitals are currently cocooning against pertussis and over 30 OB/GYN providers are cocooning against pertussis and influenza. It is recommended that all members of the family get vaccinated to better protect the newborn.

The Vaccines for Children (VFC) Program is available for those who may not be able to afford vaccines. This program provides no cost vaccines recommended by the Advisory Committee on Immunization Practices and the CDC to children 18 years of age and younger. To be eligible for the program, the child must be uninsured, underinsured, American Indian, Alaska native, enrolled or eligible for Medicaid or enrolled in Nevada Check-Up. To find a VFC provider near you, visit www.immunizenevada.org and click on the Find a VFC Provider Near You button. A provider can ask for $16.13 for each vaccine administered, but if the parent cannot afford this, the child can still be vaccinated free of charge.

In addition to these programs, the state of Nevada has an immunization registry called Nevada WebIZ. An immunization registry is an online database that makes it possible for doctors, nurses, hospitals, schools and local public health entities to keep track of and enter information to a person’s official immunization record in one place.

Immunization Information

Losing an immunization record could result in your child being turned away from school, daycare or summer camp.

Because Nevada WebIZ is an online database, a new record can always be reprinted. Nevada WebIZ eliminates the fear of losing your child’s immunization record and can also be used to track adult immunizations

www.cdc.gov/vaccines/parents www.chop.edu/service/vaccine-education-center www.pkids.org www.shotbyshot.org www.facesofinfluenza.com www.soundsofpertussis.com www.ecbt.org www.vaccines.gov www.flu.gov

State law requires the confidentiality of all information entered into Nevada WebIZ. The information is only available to doctors, nurses, schools and other medical professionals.

While Nevada law requires all vaccinations given to children and adults to be entered into Nevada WebIZ, it is possible to decline this service at your doctor’s office.

Parents want to give their children every chance to thrive.

Vaccinations are not only important, they are essential.

According to the CDC, this country has the safest, most effective vaccine supply in history, and immunization rates are near record high levels. Less than 1 percent of children have not received any vaccines. However, there are some children who are only partially immunized because they haven’t received the required vaccines on schedule, leaving them vulnerable to disease. Check with your pediatrician to ensure no doses have been skipped and to find out if your child is due for any vaccinations. Your child’s health may rely on it. We hold the power to protect our children from the devastating consequences that can arise from the lack of immunization. Act early. Act smart. Immunize today.

Nevada Immunization Coalitions

www.immunizenevada.org • www.snicnv.org

Nevada Health Departments

go online or call to find out immunization clinic days/times

Carson City Health & Human Services

www.gethealthycarsoncity.org/en/clinic/overview.html 800 E. Long St., Carson City • 775-887-2195

Southern Nevada Health District

www.southernnevadahealthdistrict.org/immunizations 702-759-0850

East Las Vegas Public Health Center 570 N. Nellis Blvd, Las Vegas

Henderson Public Health Center 520 E. Lake Mead Parkway, Henderson

Mesquite Public Health Center 830 hafen lane, mesquite

Washoe County Health District

Every state has an immunization registry to help ensure people receive their vaccination schedule.

www.co.washoe.nv.us/health/cchs/imm.html 101 East Ninth St., Building B, Reno • 775-328-2402

immunize nevada babies

nevada’s simplified childhood immunization schedule Immunization HepB

Birth

2 Months

4 Months

6 Months

12 Months This schedule uses the earliest

1

(hepatitis b)

4

DTaP

to protect babies by one year

(diptheria, tetanus, pertussis)

IPV

of age, and is compatible with

(polio)

Hib

the recommendations of the

2

(haemophilus influenza type b)

CDC, the Advisory Committee

PCV

on Immunization Practices,

(pneumococcal conjugate)

RV

2

the American Academy of

(Rotavirus)

Influenza

intervals between vaccinations

3

(flu)

Pediatrics and the American Academy of Family Physicians.

MMR

(Please note: Further doses

(measles, mumps, Rubella)

Varicella

of vaccines are still needed

HepA

beyond babies 1st year of life)

(chickenpox) (hepatitis a)

1) Your infant may not need a dose of hepb at 4 months if a dose was given at birth and a 2 months.

2) Your infant many not need a dose of hib or Rv vaccine at age six months depending on the type of vaccine your provider uses.

3) flu recommendations change every year for children. check with your doctor for the newest recommendation. the cdc recommends that everyone 6 months of age or older receive a flu shot/mist every year.

4) this dose of dtap may be given as early as 12 months if it has been 6 months since the previous dose and you think you might not return for more shots by the time your child is age 18 months.

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NEWBORN BABIES

7

Screen Test Without proper treatment, an infant with a diagnosed disorder faces illness, possible brain damage, developmental delays, and even death b y

b r i d g e t

M e a d e

Negative medical test results are scary for anyone. For the parent of a newborn who failed a hearing, genetic, or inherited disorder test before taking their baby home for the first time, it is devastating. However, that test result gave their baby the best chance at a normal, happy life.

Required by Nevada state law, all newborns are screened for disorders that are often not immediately visible. Testing for genetic, inherited, and hearing disorders is conducted within 24-48 hours of birth.

For genetic and congenital disorders, a small sample of the infant’s blood is placed on filter paper. Then doctors test it for 30 primary and 25 secondary metabolic, endocrine, hemoglobin, and genetic disorders and cystic fibrosis. For hearing, doctors use technology to gauge how sound travels from an infant’s ears to their brain.

Receiving appropriate formula within the first two weeks of life is critical to prevent irreversible mental retardation for infants diagnosed with PKU.

“It isn’t easy watching your child go through that so young,” said Melissa Reslock, mother of two young children. “However, the test is necessary to make sure the babies are healthy.”

Reslock is right. While the initial tests are not a diagnosis, it’s an important first step if the baby’s blood sample does not pass. The initial result is followed by a diagnosis and then a determination of the best treatment for the child.

Immediate treatment can mean the difference between developmental delays and a normal life for the child.

In Nevada, approximately one infant per week is identified with a condition screened for on the panel. Without proper treatment, an infant with a diagnosed disorder faces illness, possible brain damage, developmental delays, and even death. If the infant fails their hearing test and a doctor does not further examine it, the baby could miss out on the critical time for learning language (whether it be spoken or signed).

That’s where State of Nevada Newborn Screening Program (NBS) comes into play. Started in 1978, NBS’s mission is to ensure proper diagnosis, case management, evaluation, and education of the families and medical providers regarding rare conditions identified in the screening process.

8

NEWBORN BABIES

A Metabolic Disorder Story Jodi Mohorvich and Scott Cody welcomed their second son Paul into the world Oct. 12, 2011. Since their 4-year old son Karl was healthy, the news that Paul did not pass his genetic screening test came as a shock.

Less than two weeks later, the doctor called with the news.

Paul had a rare metabolic condition called phenylketonuria (often referred to as PKU). Found in one in 20,000 children in the United States, PKU means that a body is unable to properly break down an amino acid called phenylalanine.

Paul cannot digest protein and would need to adhere to a strict diet to prevent severe mental and physical developmental delays.

“It was the day before Nevada Day when the doctor called us with the news,” Mohorvich said. “The next morning, Nevada Early Intervention Services’ dietician Janice Graham was at my house at 9 a.m. with special formula for Paul.”

Receiving appropriate formula within the first two weeks

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of life is critical to prevent irreversible mental retardation for infants diagnosed with PKU. Graham keeps a box of formula in her office for such occasions. The formula has to be ordered from out of state and waiting a day or two for it to arrive is too long.

It wasn’t an easy holiday weekend for Mohorvich and her family. Learning that their son would have to be on a special diet for the rest of his life was hard to grasp.

It took a few days but Mohorvich realized she and her husband had done everything right for Paul. While they knew they had a lot of work ahead of them, they had him on special formula. They had begun preparing for his future by teaching Karl about his brother’s diet.

“Thank God for Nevada Early Intervention Services,” Mohorvich said. “As Paul gets older, we’ll have to make sure his schools are aware of his needs. However, he won’t have any signs of PKU other than his diet.”

At 7 months old, Paul is tracking well with his diet. He is in the 95th and 97th percentile for height and weight.

He’s sitting, responding to and mimicking sounds, and is a happy baby.

Baby’s First Tests Newborn Screening Program for congenital and inherited disorders What are newborn screenings (NBS) and why are they important?

Newborn metabolic screening is a blood spot test to check for the presence of certain disorders. The baby’s heel is pricked, a few spots of blood are collected on special specimen paper, and the specimen is sent to a laboratory to be screened for 30 primary and 25 secondary rare, but serious, conditions. Babies should be screened between 1-2 days after birth and again between the ages of 10-14 days.

Infants born with one of the disorders identified may appear normal at birth. However, with time, the disorder affects the infant’s health and development. By the time symptoms appear, damage may be permanent or even cause death.

While the conditions screened for on the NBS panel may be rare, they are extremely devastating to both the infant and the family. Early diagnosis and treatment often results in normal growth and development. The cost of not detecting one of these conditions is immense, both in human suffering and financial terms. If a condition is identified early, the baby can get specialized medical care, diet, and nutritional supplements. With this medical help, the baby will have an opportunity to live a full and productive life!

Does the NBS specimen hurt my infant?

“It means separate meals for each child,” she said. “He eats a lot of fruits and vegetables since he cannot have a lot of foods like dairy, eggs, pasta, and tofu.”

Keeping Paul healthy is not cheap. Mohorvich and her husband are fortunate to have good insurance to help subsidize the cost but Paul will be on a special formula for the rest of his life. He will also require modified foods for the rest of his life.

“For example, a box of pasta at Wal-Mart is about $1,” she said. “The same size box of modified pasta is $9.50.”

Fortunately for Mohorvich’s family and others, the state of Nevada passed legislation in 1997 requiring insurance companies to cover metabolic formulas. The Newborn Screening Program also offers quarterly clinics taught by Dr. Nicola Longo, Professor and Chief of Medical Genetics/Pediatrics at the University of Utah to help educate parents and physicians to learn more about metabolic diseases.

“Metabolic diseases are rare,” Dr. Longo explained. “For each gene, we have two chromosomes. The likelihood that one chromosome is bad is high but it doesn’t affect us.

However, when our partner has the same bad chromosome, there is a 1 in 4 chance our children will be affected.”

Even when parents discover their child has a rare genetic or inherited disease like PKU, Dr. Longo, the Newborn Screening Program, and dieticians stress the treatability as long as immediate action is taken once diagnosed. Resources like Dr. Longo’s clinic and parent support groups are also available.

The baby’s heel is pricked and four blood drops are collected on the filter paper included in the screening kit. Infants may cry when this happens but the discomfort is short-lived and temporary. “It isn’t easy watching your child go through that so young,” said Melissa Reslock, mother of two young children. “However, the test is necessary to make sure the babies are healthy.”

Why should your baby have blood spot screening?

• • ••

Every child’s life is valuable. The sooner a condition is diagnosed, the better the chances are for a good outcome.

Early diagnosis decreases the chance of infant death and may reduce the costs of long-term care.

Early diagnosis helps decrease parental anxiety.

Parents will need to know the baby’s diagnosis as it is possible that other members of the family may be affected.

What should you do if your baby has a screening that is not in the normal range?

TRY NOT TO PANIC! An abnormal screening does not necessarily mean that your baby has the disorder. A screening is not the same as a diagnostic test. It only provides preliminary information that must be followed up with more specific diagnostic testing.

What steps do you take if the screening is abnormal?

• • • •

Listen to the recommendations of the screening laboratory and the Newborn Screening Follow-up team.

Your baby may be sent to a specialist to confirm if he or she has the conditions found during screening.

Follow the specialist’s directions for testing and for baby’s care when the results of the test come back.

Early identification and treatment makes a difference in your baby’s lifelong development!

REMEMBER THAT YOU, YOUR BABY, AND YOUR FAMILY ARE NOT ALONE. YOUR BABY’S DEVELOPMENT AND FUTURE IS IMPORTANT! A TEAM IS AVAILABLE TO PROVIDE HELP AND SUPPORT.

Who are members of the support team?

• • • • •• •

YOU AND YOUR FAMILY – learn about your baby’s condition and any special needs that you can provide to help your baby reach his potential YOUR PRIMARY CARE PHYSICIAN and his staff – they will provide medical guidance for your baby on a regular basis MEDICAL SPECIALISTS that know about your baby’s condition and the special care that might be required SERVICE COORDINATORS that will help coordinate a variety of services for the baby and the family DIETICIANS that can provide nutritional advice and help THERAPISTS that can help with speech, language, hearing, and physical development COUNSELORS that can provide a range of advice and support for both the baby and the family

Newborn Screening Program Manager: Mary Pennington, Carson City (775) 684-3478 mpennington@health.nv.gov

Newborn Follow-up Coordinator: Dawn Lopresti, Carson City (775) 684-5889 dlopresti@health.nv.gov

Educational Coordinator for Parents Cathy Robinson, Carson City (775) 684-3476 and Medical Professionals: crobinson@health.nv.gov Registered Dietician: Shirley Farkas, Las Vegas (702) 486-9263 sfarkas@health.nv.gov

Registered Dietician: Janice Graham, Reno, Nevada (775) 688-1341 jgraham@health.nv.gov

“Helping parents cope is a huge component of ensuring the baby stays healthy,” Graham said. “I do everything from helping them with their diet to contacting insurance companies and ensuring the cost of special formula and food is covered.” a special advertising supplement to the Reno News & Review / www.health.nv.gov /

NEWBORN BABIES

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Newborn Hearing Screening Infants must be screened for hearing loss to ensure they keep up with their peers b y

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Hearing loss is one of the most common problems in newborns. Some 12,000 children in the United States are born with hearing loss each year, according the National Center for Hearing Assessment and Management.

Left undetected, hearing loss can negatively impact a child’s speech and language development and academic achievement. Fortunately, with early detection and intervention, children who are deaf or hard-of-hearing can learn at the same pace as children with normal hearing.

According to the Nevada Early Hearing Detection and Intervention (EHDI) Program, hospitals with more than 500 births per year are required to screen a newborn’s hearing prior to discharge. If a baby is born at home or is not screened for hearing loss before leaving the hospital, they should be screened within the first month after birth. The hearing screening is safe and painless. If the infant does not pass the initial screening, the parents should bring the baby back as an outpatient to be rescreened. Infants that do not pass the re-screen will be referred to an audiologist for a complete evaluation prior to three months of age. If the baby is identified with a hearing loss, early intervention by 6 months of age gives the infant the best chance of learning language.

“If a baby does not pass the hearing screening, there is a chance he may have hearing loss.”

- Dr. Diane Miller If an infant does not pass the screening, it does not automatically mean the baby is deaf or hard-of-hearing.

Dr. Diane Miller, audiologist with the Nevada EHDI Program indicates that the only way to know for sure is to have further testing. “If a baby does not pass the hearing screening, there is a chance he may have hearing loss.

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NEWBORN BABIES

The only way to know how much your baby can hear is to have an additional, more thorough, hearing evaluation by an audiologist with the expertise and equipment to test infants.”

diane Miller

For many parents, the results of the hearing screening are the first indication that that their child is deaf or hard-of-hearing.

The EHDI Program warns that without hearing screening, it is very difficult to detect hearing loss in infants. Babies with hearing loss may babble, cry and can become frightened or surprised by loud noises just as babies with normal hearing do. Hearing loss can range in severity.

Infants that are hard-of-hearing may only miss the softest sounds of speech, while others may only hear very loud noises but not voices. Infants that are deaf generally have difficulty hearing all sounds. Fortunately, with early intervention and the use of hearing technology, deaf and hardof-hearing children can and do succeed in communication and education.

Most babies who are deaf or hard-of-hearing are born to normal hearing parents.

If a child is diagnosed with hearing loss, his or her parents have a large support team that is available at little or no cost.

This support often comes from a family–centered early intervention program. The support team usually includes an audiologist, a developmental specialist or teacher of the deaf, and a speech-language therapist.

As your child’s parent, you are an important member of your child’s team. Many parents also benefit from speaking with other parents who have gone through the process of raising a child who is deaf or hard-of-hearing.

It is important for parents to know that their baby’s hearing should be screened before leaving the hospital. Be sure to ask the nurse for your baby’s results and if your baby needs additional testing. Although rare, hearing loss can develop after you baby passes the hear-

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ing screen and leaves the hospital. Benchmarks for healthy hearing include quieting to familiar voices at two months of age, searching for sounds with the eyes at four months of age, turning the head towards sounds at six months of age, and giving a toy when asked at one year of age. The EHDI Program encourages parents that have concerns about their child’s hearing or language development to schedule an appointment with an audiologist. A child’s hearing can be tested at any age.

For more information please visit health.nv.gov/NCCID_NewbornHearing.htm or call 775-684-4285

Hear hear!

Carson roller & Owen Swanson

State of Nevada’s Early Hearing Detection and Intervention Program the purpose of the Nevada early Hearing detection and intervention (eHdi) program is to ensure that all children in Nevada are screened for hearing loss at birth and those identified with hearing loss receive timely and appropriate audiological, educational and medical intervention. We promote the national eHdi goals and timelines developed by the Joint Committee on infant Hearing and the Centers for disease Control (CdC):

1

before ONe month:

2

before tHree months:

3

before SiX months:

HEARINg ScREENINg HEARINg EvAluAtION EARly INtERvENtION

Hearing loss is the most common birth defect, affecting approximately three out of every thousand infants. Left undetected, hearing impairments in infants can negatively impact speech and language acquisition, academic achievement, and social and emotional development. When diagnosed early however, these negative impacts can be diminished and even eliminated through early intervention. in addition to assuring screening and intervention for children with hearing loss the edHi program provides advocacy for children and families. this is done through the development of partnerships and working with community programs to create awareness and ensure access to services.

Andrea Esp, MPH, CHES

early Hearing detection & intervention Contact:

EHDI Program Coordinator Bureau of Child, Family & Community Wellness Nevada State Health Division 4150 Technology Way, Suite 101 Carson City, NV 89706 Phone: (775) 684-4272 Fax: (775) 684-4245

A Family’s Journey with Hearing Loss b y

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Cindy Roller already had her master’s in Early Childhood Education and was pursuing a master’s degree to be a school administrator when she gave birth to her son Carson eight years ago. “I pursued a career as a special education teacher because of the difficulties my brother had growing up” Roller said. “I worked with kids with disabilities so they can be successful.”

Carson’s hearing loss was identified through universal newborn hearing screening. When he did not pass the re-screen, he was referred to Nevada Early Intervention Services (NEIS) where an audiologist ran additional tests.

Carson was diagnosed with severe - profound hearing loss at one month and fitted with hearing aids at 2-and-a-half months.

Now fitted with cochlear implants, Carson is a flourishing 8-year-old. When he started kindergarten, Roller made sure Caron’s teachers and classmates knew about Carson’s hearing loss. At the start of the first grade, Roller was prepared to go in and explain his hearing implants to his classmates.

Carson stopped her on the way into school. “Mom,” he told her. “I’ve got this. You don’t have to come in.” Roller cried all the way home.

Through her experience with Carson, Roller decided to start the Nevada chapter of “Hands and Voices” four years ago with the help from folks like audiologist Diane Miller and the Early Hearing Detection and Intervention Program. “Hands and Voices” is a non-profit organization that supports families with deaf or hard of hearing children.

They focus on communication modes and methods such as American Sign Language (ASL) to help the children reach their highest potential. “Love them no matter what,” Roller tells parents. “It’s going to be OK.”

One of the families Roller connected with is the Swansons.

Amy Swanson, mother of Owen featured in the photo above with Carson, felt fortunate to have these resources for their family and people like them who have gone through the same journey. “I can’t imagine what it would be like with no “Hands and Voices” and if NEIS did not have the right equipment.” Owen is 13 months old and received his hearing aids at two months of age. Swanson went on to say, “Pregnant moms need to know about newborn screening. I didn’t know. My friends didn’t know either. Moms should be aware and need to know what the next steps are and the importance of following up.”

“I didn’t know. My friends didn’t know either. Moms should be aware and need to know what the next steps are and the importance of following up.”

– Amy Swanson Owen now has 10 signs and says mama and dada; however, Swanson is unsure if these words have meaning. Swanson smiles as she says, “Owen definitely says the word ‘bottle’ and when he wakes up at 4:00am he hollers ‘baba, baba.’”

Looking back Swanson comments on their experience so far, “Our lack of education made it scary at first. Once we got educated it was so much more manageable. Once it sunk in (that Owen had hearing loss) and we learned from talking to people and reading up and getting resources, it all came together. It’s actually been a fun journey, learning sign language and meeting everyone.”

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NEWBORN BABIES

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sleep

like a baby When the baby sleeps correctly, parents can sleep more easily b y

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Sudden infant death syndrome (SIDS) and accidental suffocation are the leading causes of death in babies 1 month to 12 months. The true cause of SIDS is unknown, but there are ways to help reduce the risk of SIDS and provide your baby with their own safe sleep environment.

“An extremely critical public health message for the last 25 years is ‘Back to Sleep,’” says Melissa Krall, Coordinator of Safe Kids Washoe County. “This means that babies are to be placed on their backs to sleep, every time.”

Safe Kids Washoe County is an organization that runs the statewide “Cribs for Kids” initiative to raise awareness of safe sleep for babies. Krall, who is also the director of Community Outreach for REMSA, is on a mission to educate folks on the importance of safe sleep.

Other ways parents can reduce the risks of SIDS before and after childbirth include avoiding exposure to smoke, drugs and alcohol during and after pregnancy, attending all prenatal checkups and breastfeeding. Providing a safe sleep environment is vital to avoid suffocation or smothering the baby and to protect the baby from a fall.

“The steps you take that help prevent SIDS are the same steps you take to safely sleep your child,” Krall said. “It’s

DOs

Babies need their own sleep surface. This means they are sleeping alone on a firm mattress in a crib or portable crib.

Also, parents must make sure there are no extra things in the crib like bedding, pillows or toys. Bumper pads are not recommended and babies should wear a single-layer of clothing to avoid over-heating. The baby’s blanket should not be placed higher than their breastbone.

Krall explained the hazards of co-sleeping with other adults, siblings or animals. “We recommend room sharing if the baby has their own sleeping environment,” Krall said. “It can be in the same proximity as the parents but not where they are in the same bed as an adult or sibling. An alarming statistic is the number of children who died while co-sleeping with an adult.”

About one in five SIDS deaths occur while the child is in the care of someone other than a parent. A child who is unaccustomed to tummy sleep is 18 times more likely to

DON’ts

Sleep your baby on his or her back every sleep time.

Do keep the room at room temperature.

Do not co-share your bed with your baby.

Do not smoke during pregnancy or after birth.

Use a firm sleep surface.

Do vaccinate you child with all the recommended infant vaccinations.

Do not take a nap on the sofa with your baby.

Do not cover the infants face.

Do not put your baby to sleep in a car seat as their regular sleep environment.

Do not overheat the baby by over dressing at bedtime.

Do not allow sibling or animals to sleep in the same bed as your baby.

Do not use home monitors of commercial devices that suggest they reduce the risk of SIDS.

Cover the baby with a baby blanket up to their breastbone.

Sleep in the same room as the baby with the baby safely in their own crib.

Do receive regular prenatal care check-ups.

Breastfeeding is recommended.

Use a pacifier at nap time and bedtime.

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the same set of rules. If you are following the rules to prevent SIDS, you are safely sleeping your baby.”

NEWBORN BABIES

Do have supervised, daily tummy time with your baby.

Swaddling is recommended so long as the baby sleeps on their back.

Talk about safe sleep practices with everyone who cares for your baby.

Do not keep toys, adult bedding, pillows or blankets in the crib.

Guidelines from the American Academy of Pediatrics (AAP)

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die from SIDS. Parents should take time to talk to their children’s caregivers about the environment and sleep positions. This is not to suggest that tummy time isn’t a good thing for babies. “It is excellent for their overall neck development and strength,” Krall said, “but this should happen during awake time.”

The “Cribs for Kids” group promotes safe sleep. They provide families with education on the importance of safe sleep practices and provide cribs to families who cannot otherwise afford a safe place for their babies to sleep.

“We ask that families share this information with everyone they contact, including their caregivers and family members,” Krall said. “Talk with siblings and grandparents in case they are left looking after the baby for any reason. Education is vital in keeping babies safe.”

Melissa Krall

Director of Community Outreach REMSA

PURPLE PEAK OF CRYING

Your baby may cry more each week.

The most at 2 months, then less at 3-5 months

UNEXPECTED Crying can come and go and you don’t know why

RESISTS SOOTHING

PAIN-LIKE FACE

LONG LASTING

Your baby may not stop crying no matter what you try

A crying baby may look like they are in pain, even when they are not

Crying can last as much as 5 hours a day, or more

1

Feed your baby. Hunger is the main reason a baby will cry.

EVENING

2

Your baby may cry more in the late afternoon and evening

Burp your baby. Babies don’t have a natural ability to get rid of air built up in their stomach.

3

Give your baby a lukewarm bath. A great soothing technique, but remember to never leave your baby unattended.

4

Massage your baby. A gentle massage on a baby’s back, arms, or legs can be very comforting.

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Make eye contact with your baby and smile. Eye-toeye contact with your baby when they are crying can distract and comfort them.

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Kiss your baby. This can help lessen the tension during fierce crying episodes.

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Sing softly. Lullabies were created because of their effectiveness at calming crying babies.

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Hum in a low tone against your babies head. Dads are usually best at this.

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Run a vacuum cleaner. The noise from a vacuum is referred to as “white noise” (any noise producing a loud, neutral, masking sound). Babies find these noises hypnotizing.

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Take your baby for a ride in the car. Vibrations from a car have a sleep-inducing effect on babies. Always make sure your baby is secure in a rear-facing car seat in the back seat.

The Period of Purple Crying Advice for new parents to help them cope with a crying baby Most new parents aren’t prepared for the volume or the amount of infant crying. There are decades of research on this early stage of crying in an infant’s life, now being referred to as a baby’s “Period of Purple Crying.”

The Period of PURPLE Crying begins at about 2 weeks of age and continues until about 3-4 months. There are other common characteristics of this period, which are better described by the acronym “PURPLE.” All babies go through this period. It’s just that during this time some can cry a lot, some far less, but they all go through it.

There are other characteristics of this stage. Studies show that the crying tends to be much heavier in the late afternoon/evening, just when parents are getting home from work and the most tired. Parents try many ways to keep the baby from crying - or stop the crying - and some of them seem to work, at least for a while. When babies are going through this period, they seem to resist soothing. Nothing helps. Even though it helps when they are fussy or crying other times, it’s different when they go through these inconsolable crying bouts. Nothing seems to soothe them.

During this phase of a baby’s life, they can cry for hours and still be healthy and normal. Parents often think there must be something wrong with them or they would not be crying like this. However, even after a check-up from the doctor showing the baby is healthy, they still go home and cry for hours, night after night.

Between the ages of 1 and 4 months, babies’ neck muscles are not strong enough to hold up their head, which at this time weighs close to 25 percent of their body weight.

Often, parents say their baby looks like he or she is in pain.

Turns out though, that the babies who are going through this period can act like that. If you have concerns about your baby, always contact a pediatrician for a complete medical evaluation.

The most important thing to remember is that all people, of all backgrounds, educational levels, financial status, race and culture go through these things with their baby. Even pediatricians have shared that they got frustrated with their own baby’s crying. The most important thing to remember when you get angry is take a deep breath, put your baby in a safe place and walk away. Never have a baby in your arms when you feel angry or resentful. It’s okay to ask for help.

Tips to help you relax and relieve your frustration: 1

Listen to music. Turn it up loud if you have to so you can’t hear the crying.

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Take a warm bath. Shut the door, indulge in bubbles, play soft music.

3 4

Watch your favorite television program.

5 6

Take a nap.

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Keep a thought journal. Writing your feelings in a journal can help you get things off your chest. This isn’t meant to be a personal history, but rather an expression of your inner feelings.

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Talk to someone. It helps to share your frustrations with others who will listen. Talk to a trusted friend or family member.

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Don’t do more than is possible in a day. Practice time management skills. Decide what needs to be done and prioritize. If it doesn’t get done, don’t sweat the small stuff.

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Put things in their place. Stress can develop in a cluttered environment. Take a few moments at the end of the day to pick up.

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Laugh and laugh often. Enjoy a comedy, tell a joke or share good times with family and friends

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Seek professional help when necessary. Sometimes we need help to deal with stresses that are too overwhelming to handle alone. Remember, it is okay to ask for help.

For more information please visit www.dontshake.org

No shame. No blame. No names. Anonymous ways to surrender your newborn.

In Nevada, the Safe Haven Infant Protection Act allows an individual to surrender an infant with no fear of arrest or prosecution. No names or records are required. Parents can bring a baby less than 30 days old to any hospital, urgent care facility, an occupied fire or police station or they can

Tips to Soothe Your Crying Infant

call 911 to have an ambulance dispatched to the location.

The appropriate government child protection agency will immediately take the newborn into custody and place the infant in a foster or pre-adoptive home.

For confidential information 24 hours a day, call 1.877.885.HOPE Answered by the Crisis Call Center of Nevada

Exercise. This doesn’t necessarily mean to go to a gym.

You can turn on an exercise video or TV program. Exercise hard. Even better, ask your spouse or relative to stay with the baby while you walk around the block. In the evening, this can be very therapeutic.

Engage in a hobby, craft or activity that you find enjoyable. It seems like you shouldn’t be doing this with a baby crying, but this can really work. Once you convince yourself that you’re entitled to have some time for yourself, keep saying this over and over to yourself.

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NEWBORN BABIES

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Taking Care of Mommy Postpartum depression can make it hard for mom to take care of baby—and herself b y

K at e t h o m a s

When a woman has a baby it can trigger many powerful feelings and emotions, ranging from happiness and joy to anxiety and overwhelming fear. It is not unusual for new moms to experience the baby blues, but when these mood swings become longer lasting forms of depression, then it is possible the mom is dealing with postpartum depression (PPD).

PPD isn’t a weakness. If anything, it is a complication of childbirth that, with prompt treatment, can be easily controlled. Birdie Meyer, RN, MA, is coordinator of Perinatal Mood Disorders at Indiana University Health and is chair of the Educational Training Committee for Postpartum Support International (PSI). Meyer has 15 years of experience with PPD, also known as a perinatal mood disorder. She says there are many misconceptions about the symptoms of PPD. “Women sometimes think postpartum depression means having horrible thoughts or crying all the time, which is not always true,” said Meyer.

RISK FACTORS

There is no single cause for PPD, and it is not clear why some women may be more vulnerable than others. The current statistics for women who suffer from a PPD stands at 1 in 8 women.

“That means that 800,000 women a year will suffer from a perinatal mood or anxiety disorder,” Meyer said. “That is close to 1 million women a year. Studies have shown that it is 10-22 percent.”

Women from every walk of life can develop PPD. Symptoms can begin to develop during pregnancy or in the first 12 months after childbirth. Certain risk factors may increase a woman’s chance of experiencing significant feelings of depression and anxiety during or after pregnancy. Also, women with a personal or family history of depression, anxiety, obsessivecompulsive disorders, panic attacks or post-traumatic stress disorders are at a higher risk. Meyer explained that many women do not even know they have a history.

“A lot of people are unaware they have a family history,” Meyer said. “For instance, if you say to someone, ‘Do you have a history of mental health or anxiety issues?’ they will say ‘No! Not that I know of.’ Yet if you ask them if they consider themselves to be a worrier, they may say, ‘Oh yes, I have always been a worrier, my mom was, too.’”

SYMPTOMS

It is important to recognize that the baby blues is a separate issue from PPD. The baby blues only last for a few days to two weeks and can include some or many of the following: mood swings, anxiety, sadness, irritability, crying, lack of concentration or trouble sleeping. “The baby blues is directly caused by the change in hormones, and it only lasts a couple of days to a couple of weeks,” Meyer said. “It is not really a diagnosis as 50 percent to 80 percent of women get

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NEWBORN BABIES

a touch of baby blues. If it goes beyond two weeks or you are really devastated, it is not the baby blues.”

Other symptoms of PPD include: eating disturbances (overeating or loss of appetite), insomnia, sadness, crying, overwhelming fatigue, lack of interest in sex, and feelings of inadequacy and intense irritability. PPD can also include symptoms of anxiety, which can manifest in a number of ways.

TREATMENT

It is important to seek help from your doctor if you are depressed after your baby’s birth even if you are ashamed, embarrassed or reluctant. The sooner a person treats PPD, the sooner they will recover, be able to bond with their child, and enjoy life with their newborn baby.

PPD is typically treated with either counseling or medicine or both depending on the severity of the case. Women with milder symptoms will have a full recovery with therapy alone, but some may need a combination of treatments.

It is also encouraged that women suffering with PPD seek as much social support as possible within their local peer groups and become educated.

If families are concerned that a new mother may be suffering from PPD, the best thing to do is to be supportive and

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to approach the topic sensitively. It is important to remember that depression is not anyone’s fault and ignoring it will not make it go away.

PREVENTION

Through education during pregnancy, mothers can prepare for and monitor any signs and symptoms of depression they may experience. The earlier PPD is detected, the earlier treatment can begin.

Always contact your physician if you are feeling the following: • • • • • •

Are you feeling sad or depressed?

Do you feel more irritable or angry with those around you?

Are you having difficulty bonding with your baby?

Do you feel anxious or panicky?

Are you having problems with eating or sleeping?

Are you having upsetting thoughts that you can’t get out of your mind?

• Do you feel as if you are “out of control” or “going crazy?”

• Do you feel like you never should have become a mother?

• Are you worried that you might hurt your baby or yourself?

Your Child at 1 Year

Act early by talking to your child’s doctor if, by 1 year, your child:

How your child plays, learns, speaks, and acts offers important clues about your child’s development. Developmental milestones are things most children can do by a certain age.

• Doesn’t crawl • Can’t stand when supported • Doesn’t search for things that

Check the milestones your child has reached by his or her 1st birthday. Take this with you and talk with your child’s doctor at every visit about the milestones your child has reached and what to expect next.

she sees you hide • Doesn’t say single words like “mama” or “dada” • Doesn’t learn gestures like waving or shaking head • Doesn’t point to things • Loses skills he once had

WhAt mOSt chIldREN dO At thIS AgE: Social/Emotional

• • • • • • • •

Is shy or nervous with strangers Cries when mom or dad leaves Has favorite things and people Shows fear in some situations Hands you a book when he wants to hear a story Repeats sounds or actions to get attention Puts out arm or leg to help with dressing Plays games such as “peek-a-boo” and “pat-a-cake”

language/communication

• • • • •

Responds to simple spoken requests Uses simple gestures, like shaking head “no” or waving “bye-bye” Makes sounds with changes in tone (sounds more like speech) Says “mama” and “dada” and exclamations like “uh-oh!”

Tries to say words you say

Get it Done in Year One Dental Care is Crucial During the First Year of Life

cognitive (learning, thinking, problem-solving)

• • • • • • • • • •

Explores things in different ways, like shaking, banging, throwing Finds hidden things easily Looks at the right picture or thing when it’s named Copies gestures Starts to use things correctly; for example, drinks from a cup, brushes hair Bangs two things together Puts things in a container, takes things out of a container Lets things go without help Pokes with index (pointer) finger Follows simple directions like “pick up the toy”

Tell your child’s doctor or nurse if you notice any of these signs of possible developmental delay for this age, and talk with someone in your community who is familiar with services for young children in your area, such as your state’s public early intervention program. For more information, go to www.cdc. gov/concerned or call 1-800-CDC-INFO

Adapted from CARING FOR YOUR BABY AND YOUNG CHILD: BIRTH TO AGE 5, Fifth Edition, edited by Steven Shelov and Tanya Remer Altmann, copyright 1991, 1993, 1998, 2004, 2009 by the American Academy of Pediatrics and BRIGHT FUTURES: GUIDELINES FOR HEALTH SUPERVISION OF INFANTS, CHILDREN AND ADOLESCENTS, Third Edition, edited by Joseph Hagan, Jr., Judith S. Shaw, and Paula M. Duncan, 2008, Elk Grove Village, IL; American Academy of Pediatrics

movement/Physical development

• • •

• • • • • • • •

Gets to a sitting position without help Pulls up to stand, walks holding on to furniture (“cruising”) May stand alone

Proper care for baby teeth is imperative as they serve several critical functions, including: Fostering good nutrition by permitting proper chewing Aiding speech development Helping proper development of permanent teeth by saving space for them The American Academy of Pediatric Dentistry (AAPD), American Dental Association (ADA) and the American Academy of Pediatrics all recommend a dental visit for children by age one.

Baby teeth are vulnerable to tooth decay from their very first appearance, on average between the ages of six and 12 months.

The associative pain of tooth decay can prevent a child from eating correctly, impacting overall health and development. Additionally, undetected and untreated tooth decay can lead to infection, loss of teeth and expensive and mostly preventable emergency and restorative interventions.

A scientific paper in the journal Pediatric Dentistry revealed that children who wait to have their first dental visit until age two or three are more likely to require restorative and emergency visits.

Benefits of the Year One dental Visit

• • •

•

1 + 1 = ZERO. ONE dental visit when there’s ONE tooth can equal ZERO cavities.

Visiting a pediatric dentist by the time the first baby tooth appears enables the child to begin a lifelong preventive dental care program to minimize tooth decay and cavities.

Pediatric dentists can detect early tooth decay, provide parents with information on proper oral and facial development, determine fluoride needs and more.

The year one dental visit can actually save money. A study in the journal Pediatrics showed that children who have their first dental visit before age one have 40 percent lower dental costs in their first five years than children who do not, due to the cost of dental and medical procedures that may be necessary as a result of poor oral health.

Recommended At-home dental care during Year One

• • • • • •

Even before baby teeth appear, infants need proper oral care and fluoride supplements to help developing teeth grow strong and avoid early childhood caries.

Parents should clean infant mouths and gums regularly with a soft infant toothbrush or cloth and water.

Children older than six months need fluoride supplements if their drinking water does not contain enough fluoride. Fluoride supplementation in infants has been shown to reduce tooth decay by as much as 50 percent.

Infants and young children have other unique caries-risk factors including development of dietary habits and childhood food preferences. Breastfeeding at will should be avoided after the first primary tooth begins to erupt and other dietary carbohydrates are introduced.

Parents should be encouraged to have infants drink from a cup as they approach their first birthday. Infants should be weaned from the bottle by 12-14 months of age.

Baby teeth should be brushed at least twice a day with an ageappropriate sized toothbrush using a “smear.”

American Academy of Pediatric Dentistry • 211 East Chicago Avenue, Suite 1700 • Chicago, IL 60611-2637 • (312) 337-2169 • www.aapd.org July 28, 2010

a special advertising supplement to the Reno News & Review / www.health.nv.gov /

NEWBORN BABIES

15

Resources: NATIONAL American Academy of Pediatric Dentistry:

www.aapd.org

American Academy of Pediatrics

www.aap.org

Centers for Disease Control and Prevention

www.cdc.gov Cribs for Kids

Safe Kids Washoe County

www.Safekidswc.com or 775.858.5700 (Nevada Cribs for Kids Contact)

Mesquite Public Health Center 830 Hafen Lane, Mesquite

Women, Infants, and Children Program

Safe Kids Clark County

http://health.nv.gov/wic.htm

CArSON CITy

www.Cribsforkids.org

Carson City Health & Human Services

National Center on Shaken Baby Syndrome www.dontshake.org or

800 E. Long St., Carson City

1.801.447.9360

www.gethealthycarsoncity.org/ en/clinic/overview.html

Text4baby

www.Text4baby.org The Period of Purple Crying

www.purplecrying.info or 1.801.447.9364

STATewIde NV 211 Nevada Immunization Coalitions

Regional Emergency Medical Services Authority (REMSA) Point of Impact Car Seat Safety Program

775.684.4272

Educational Coordinator for Parents and Medical Professionals Cathy Robinson, Carson City

775.684.3476

crpbomspm@health.nv.gov

Nevada Health Departments go online or call to find out immunization clinic days/times

dlopresti@health.nv.gov

Safe Haven

www.safehavennv.org or 1.877.885.HOPE

www.southernnevadahealthdistrict.org/immunizations or 702.759.0850

Early Hearing Detection & Intervention Andrea Esp, MPH, CHES EDHI Program Coordinator Bureau of Child, Family & Community Wellness Nevada State Health Division 4150 Technology Way, Suite 101 Carson City, NV 89706

Newborn Follow-up Coordinator Dawn Lopresti, Carson City

http://health.nv.gov/ NCCID_NewbornHearing.htm 775.684.4285

Southern Nevada Health District

wAShOe

www.immunizenevada.org www.snicnv.org

Newborn Hearing

www.safedidsclarkcounty.org or 702.731.8666

775.887.2195

Postpartum Support International

www.postpartum.net or 1.800.944.4PPD

Henderson Public Health Center 520 E. Lake Mead Parkway, Henderson

775.684.5889

Newborn Screening Program Manager Mary Pennington, Carson City

775.684.3478

mpennington@health.nv.gov

CLArk East Las Vegas Public Health Center 570 N. Nellis Blvd., Las Vegas

www.remsa-cf.com/poi.html or 775.858.KIDS Registered Dietician Janice Graham, Reno, Nevada

702.688.1341

jgrahyam@health.nv.gov Washoe County Health District www.co.washoe.nv.us/health/cchs/imm.html 101 East Ninth St., Building B, Reno

775.328.2402

ImmuNIzATION web SITeS www.cdc.gov/vaccines/parents www.chop.edu/services/ vaccine-education-center www.pkids.org www.shortbyshot.org www.facesofinfluenza.com www.ecbt.org www.vaccines.gov www.flu.gov