The Province

Keeping newborns and toddlers safe

- LEANNE ITALIE

NEW YORK — Bringing a newborn home can be daunting for new parents. Throw in the race to keep up with the latest news and research on what to do after that and stress levels may rise even higher.

Dr. Tanya Altmann, a pediatrici­an, professor and an American Academy of Pediatrics (AAP) spokeswoma­n, provides answers to parents’ top 150 questions in a newly released book, Baby & Toddler Basics.

Here’s a look at some updates over the past few years:

Introducin­g solids

In her practice, Altmann starts babies on all sorts of healthy foods around six months of age.

“I usually start with avocado and veggies. I try to get in some healthy fats like nut butters and fish, and all sorts of healthy things that parents used to say, ‘Oh my gosh, why would I feed that to my baby?’ ” Altmann said.

In terms of allergen introducti­on, one study out of Israel cited by Altmann introduced peanut protein to babies four months to 11 months of age three times a week with good results, she said.

“That doesn’t mean whole peanuts. It means a peanut powder or a peanut puff,” Altmann said.

She cautions parents to make sure such foods are forms babies can handle to avoid choking hazards.

And consulting a physician first is key as peanut-allergy testing prior to introducti­on might be needed, Altmann said.

Crib safety

About 3,500 sleep-related deaths, including sudden infant death syndrome and suffocatio­n, among U.S. babies occur each year, the U.S. Centers for Disease Control said, with 22 per cent of mothers reporting they do not place their babies on their backs to sleep, as recommende­d. Other advisable safe sleep practices today include eliminatin­g hazards altogether, including keeping blankets, pillows, bumper pads and soft toys out of cribs and bassinets.

Fluoride toothpaste

After the first tooth erupts, a little bit of fluoride for infants is important for promoting dental health, Altmann said.

“We used to recommend just brushing with plain water or fluoride-free toothpaste until children could spit on their own. The more recent guidelines (dating to 2014) are to use just a tiny, tiny smear of fluoride, like the size of a grain of rice, on your baby’s toothbrush,” she said.

Toddlers likely still need help brushing properly, Altmann noted. For young preschool or schoolage children, parents might let a child brush on their own in the morning under supervisio­n but more actively assist at night.

Car seats

Rear-facing remains the safest, Altmann said, but previously the recommenda­tion was until at least a year, when “everyone would flip their child around.”

Now the research shows a child should remain rear-facing in a car seat until age two or older, she said.

Height and weight should also be monitored to make sure car seats remain safe as babies grow.

Fever anxiety

Altmann’s best advice: “Don’t let the number freak you out.”

For babies over three months old, the number may not matter as much, she said. Parents know their babies best and must take into account all symptoms, Altmann said. In babies younger than three months, any temperatur­e reading of 100.4 F (38 C) or higher should prompt a call to a pediatrici­an, she said. For infants three to six months, it’s 102 (F, or 38 C) or higher, Altmann said. For babies older than six months, it’s 104 (F, or 40 C) or higher.

In terms of thermomete­rs, the “gold standard” for newborn remains rectal devices, she said. For older kids, length of fevers, extended loss of fluids or trouble breathing should mean a trip to the doctor, Altmann said.

 ?? — AMERICAN ACADEMY OF PEDIATRICS ?? Dr. Tanya Altmann tackles parents’ top 150 questions in her new book, Baby & Toddler Basics.
— AMERICAN ACADEMY OF PEDIATRICS Dr. Tanya Altmann tackles parents’ top 150 questions in her new book, Baby & Toddler Basics.

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