Ask the ex­perts

Ad­vice and wis­dom

Mother & Baby (Australia) - - Contents -

OPEN BITE AHEAD?

Q Will thumb-suck­ing make my baby buck-toothed? A Early child­hood health nurse

Sharon Don­ald­son says: Ba­bies and tod­dlers suck­ing on thumbs, fin­gers and toys is con­sid­ered healthy be­hav­iour. Most chil­dren will stop suck­ing be­tween the ages of two and four, how­ever, thumb-suck­ing after four years of age may af­fect a child’s speech, bite and their ap­pear­ance.

Be­tween the ages of six and seven, when the per­ma­nent teeth start to erupt, con­tin­ued thumb-suck­ing may cause teeth to grow out of line. Buck teeth and an open bite may re­sult from ha­bit­ual thumb- or fin­ger-suck­ing. Your child may also de­velop a lisp, when try­ing to say the ‘s’ sound, it be­comes ‘th’.

Preven­tion is bet­ter than cure. So if your child con­tin­ues to suck their thumb or fin­ger after the age of two to three, you may need to ad­dress this habit to avoid any prob­lems in the fu­ture.

The best way to deal with thumb- or fin­ger-suck­ing is through pos­i­tive re­in­force­ment, and avoid­ing neg­a­tive words or be­hav­iour. Your child is only do­ing what feels nat­u­ral. En­cour­age, praise and re­ward your child when he is not suck­ing his thumb or fin­ger. And con­sult your den­tist, GP or pae­di­a­tri­cian if you have any con­cerns.

EARLY BIRD

Q If I put my daugh­ter to bed later, will she sleep in for longer? She’s nearly eight months old. A Early child­hood health nurse

Sharon Don­ald­son says: All ba­bies wake overnight, and many are in­clined to be early wak­ers. Gen­er­ally, putting her to bed later wouldn’t usu­ally make her sleep in for longer.

How your baby girl goes off to sleep and how she re­set­tles will de­ter­mine her sleep pat­terns, and the length of time she sleeps. In other words, if your daugh­ter is en­cour­aged to go to sleep awake in her cot, with­out the use of sleep aids or be­ing rocked or breast­fed to sleep, then she will learn bet­ter the abil­ity to set­tle and re­set­tle for all of her sleeps.

Cre­at­ing a con­sis­tent bed­time rou­tine around 6.30pm to 7pm each night is a good start to­wards healthy sleep habits. Din­ner, bath, py­ja­mas, milk feed, then story and a kiss good­night is a typ­i­cal bed­time rou­tine for fam­i­lies.

An eight-month-old baby will still need two day­time sleeps, and is likely to be hav­ing three solids per day with op­tional snacks. She may still need a milk feed at around 10pm, but wouldn’t need any milk feeds overnight.

Fo­cus­ing your ef­forts to­wards healthy, con­sis­tent set­tling meth­ods will help your daugh­ter achieve the abil­ity to set­tle and re­set­tle. Re­mem­ber that ‘sleep pro­motes sleep’, so the more your baby sleeps, the more sleep she will want.

COM­ING BACK UP

Q I’ve heard of silent re­flux. What’s the dif­fer­ence be­tween that and nor­mal re­flux, and how will I know if my baby has it? A Pae­di­a­tri­cian Mike Starr

says: Gas­tro-oe­sophageal re­flux is when stom­ach contents are brought back up ei­ther into the oe­soph­a­gus or mouth. Some­times, acid from the stom­ach is brought back up as well. This may cause ir­ri­ta­tion to the oe­soph­a­gus and can be dis­tress­ing for the baby. Ba­bies with re­flux usu­ally vomit. The term ‘silent re­flux’ is some­times used to mean stom­ach contents and acid be­ing brought back up with­out vom­it­ing. Ex­perts dis­agree about whether silent re­flux re­ally ex­ists. Re­flux gen­er­ally re­solves by it­self and does not re­quire any treat­ment.

NUTS TO THAT

Q My sis­ter has a se­ri­ous peanut al­lergy. Does that mean I shouldn’t give my baby peanuts? A Nutri­tion­ist Dr Joanna McMillan

says: There is no ev­i­dence that de­lay­ing or avoid­ing po­ten­tially al­ler­genic foods re­duces the risk of your child de­vel­op­ing an al­lergy. In fact it may even in­crease the chance, although more re­search is needed to con­firm this. The In­fant Feed­ing Guide­lines in Aus­tralia rec­om­mend ex­clu­sive breast­feed­ing for around six months, be­fore solid foods should be in­tro­duced in no par­tic­u­lar

TUG-O-HAIR

Q My 14-month-old pulls other chil­dren’s hair at play­group. Should I dis­ci­pline her or wait for this phase to pass? A Child psy­chol­o­gist Sally-Anne McCormack

says: This is a good ques­tion be­cause par­ents are of­ten un­sure about telling their child not to do some­thing and risk­ing the child en­joy­ing the at­ten­tion, then re­peat­ing the be­hav­iour.

The in­ter­est­ing thing with the word ‘dis­ci­pline’ is that some peo­ple might think it means ‘pun­ish­ment’, how­ever it ac­tu­ally means ‘to teach’.

The best strat­egy for a 14-month-old is to sim­ply re­move her from the group for a few min­utes. She will learn that the ‘con­se­quence’ of pulling some­one’s hair is that she does not con­tinue play­ing with them. or­der. Whole nuts are, of course, a chok­ing risk and should not be given to chil­dren un­der four, but nut but­ters are nu­tri­tious for young chil­dren. My ad­vice is that once your child is eat­ing fin­ger foods, try giv­ing him a tiny amount of peanut but­ter on toast. Do this when you are close to med­i­cal help in the un­likely event that you should need it. See your GP or health pro­fes­sional if you have any con­cerns.

HEAR, HEAR

Q We have had to take my 20-month-old daugh­ter to the doc­tor re­peat­edly with ear in­fec­tions. Is this nor­mal, and how can I pre­vent her from re­peat­edly get­ting them? A Pae­di­a­tri­cian Dr Scott Dunlop

says: Ear in­fec­tions are very com­mon in child­hood, par­tic­u­larly if there is fre­quent con­tact with other chil­dren, as viruses are the usual cause. An­tibi­otics are some­times re­quired for bac­te­rial mid­dle-ear in­fec­tions. While hav­ing ear in­fec­tions is not ab­nor­mal, if they are fre­quent, we do worry about the pos­si­bil­ity of fluid build-up in the in­ner ear, and the re­duc­tion in hear­ing that can oc­cur as a re­sult. This can some­times af­fect speech de­vel­op­ment.

In most cases, you can’t pre­vent ear in­fec­tions with­out iso­lat­ing your daugh­ter from other chil­dren. Fluid build-up can some­times be man­aged with pro­longed an­tibi­otics.

If there is con­cern re­gard­ing in­ner ear fluid and hear­ing im­pair­ment, con­sult your GP. He or she will usu­ally re­fer you to an ENT (ear, nose and throat) sur­geon who will dis­cuss in­ser­tion of grom­mets (small drainage tubes) to al­low fluid to drain away. This in­volves a brief anaes­thetic in hos­pi­tal.

DR SCOTT DUNLOP DR JOANNA MCMILLAN SALLY-ANNE MCCORMACK DR MIKE STARR SHARON DON­ALD­SON

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