Baby Medical Advice, Part 2

Wendy Turner: Its start time again to go through the mail back and answer some of the many, many questions that you sent in toward Doctors in mid wise. Today Su Laurent consultant pediatrician at Barnet Hospital and baby channel medical advisor is going to answer all your baby queries. Hello, Doctor Su. Dr. Su Laurent: Hi! Wendy. Wendy Turner: Alright, let’s crack on. First of Charlotte from Kent has got in touch with us. Could you please tell me the best way to transfer from breast to bottle feeding, my baby is five months old? I was advised by the way to go completely cold turkey on that, painful as it works for a few days. What you think? Dr. Su Laurent: I think it depends very much on why you want to transfer and how you want to do it. For example, if you’re going back to work and you want to do some bottles during the day, but some breast feeds morning and evening as many women do then you might want to do it in one way where she just want to go cold turkey that’s another way to do it. Now how to do it, the bottom line is that your baby, if your baby has been fully breast fed and he has never had a bottle would probably not likely idea, I’m going to bottle to begin with. My recommendation is to get someone else to do it for you. Wendy Turner: Oh, really? Dr. Su Laurent: So in other words, if you got a partner, if you got a friend, parent around, say, I’m going out. It’s a great opportunity to go out with a bit of time off as well and to say, here is the bottle and if you’re not there and the baby can’t see you and smell you and know there is always going to breast as an option, then the baby will get hungry and thirsty and will have no option let’s take the bottle. Wendy Turner: For the poor mother, of course, who physically is suffering in his delicate area, what sort of tips have you got? So that sort of less in the pain? Dr. Su Laurent: Where I personally have always reduced gradually, so I’ve always gone from sort of fully breast feeding to maybe going to down to say, two feeds a day because I was like to kind come and drag it out of it particularly, when I went back to work I like the idea of coming back in breast feeding at night, and first thing in the morning. So, I don’t think that I’ve ever suffered from suddenly being all full to busting and then pain and I think I did it gradually. Wendy Turner: You’ve always, you never had the cabbage leaves? Dr. Su Laurent: Oh, well -- no, early on the cabbage leaves are fantastic, the ones that you stick in the fridge or freezer, and then you stick them in your bra that really good for early on when you got those big really, when you’ve actually weaning off, I don’t never used cabbage leaves when you’re weaning off breast feeding. Wendy Turner: I think I do scientific. Dr. Su Laurent: Alright, yes that’s helpful. Yeah. That certainly helps just get a lot sort of pressure away and the pain away or it is a bit smelly cabbage leaves. Wendy Turner: Oh, absolutely that’s disgusting. Dr. Su Laurent: Yeah. Wendy Turner: Alright, sure let’s take that time bit of -- made a bit of sense to you. Alright, next off. My son is seven months old and he is sick after every bottle, he brings up about three ounces of his feed. Can you tell me why he is so sick and what I can do? I mean that presumably isn’t right, but a baby would you know throw up a lot of the milk back again? Dr. Su Laurent: Well, it’s very common. Some babies are just what we call sicky baby’s they’ll always bring up some of their milk. Now the common course condition is it causes vomiting in babies after every single meal, something we call Reflux or to give it a proper name Gastro-oesophageal reflux. What happens is that normally milk goes down in the mouth through the oesophagus into the stomach and most of it stays down there, but not all of it stays down there with all of us, we can all vomit if we need to and we can all bark, if we need to. So, we need to able to have some capacity for milk to come backup again, but with some babies what happens is to much comes up again and you’ll notice that particularly of the feeds that they got a full stomach, and then sounds like comes back up again or you put them to sleep, and then they vomit because, of course, they haven’t got their glands of gravity, when you’re sitting out you got gravity. If a baby has this condition reflux, there are three different source of reflux they can have. One is mild reflux and which is probably what this little boy has got who is seven months old. Mild reflux just means that milk comes and it’s a great inconvenience because you’ve got vomit over you as parent, you’ve got vomit over the baby, but actually the baby carries on growing, isn’t distress and everything carry on this normal and you can cope with that on no particular treatment and just say, I’ve got a sicky baby and in time bell out grow it. Wendy Turner: So how we got to remember that it actually not being sick in the way that we think of vomiting itself? Dr. Su Laurent: Yeah, it’s not being, yes, I mean let me think of us vomiting, or older children vomiting got an infection or they’ve got a -- there is something wrong with them and they or they have some food poison something like that, and then obviously it’s an acute thing. This is baby who just for mechanical reasons can’t keep all their milk down. Some babies, who vomit a lot actually -- taken down lots of air with feeds or taking down huge volumes more than they actually need, so they just vomit back out what they don’t actually need. Quite often with babies and as they have more solid food and this little boy who is seven months old, I would hope he would start to get better because as he more solids and therefore has less of his food as milk, it should be better. However, there are treatments, there are medical treatments that you can have for vomiting babies and it is worth talking it through with the health as it hold with the GP is that the vomiting continuing you may wanted to use a medicine to help keep the food and the milk down further and help the stomach empty faster, so that there is not much hanging around in the stomach. Wendy Turner: Well, okay that’s wrapped up. Something called a croup, my son is 33 days old and he had a croup for two weeks -- sorry from two weeks old, it wakes him up at night and he is very up setting and he is especially bad at night. I’ve tried steam treatment, but nothing is helping, have you any advice? Now I’ll take note, what is croup? Dr. Su Laurent: Well, let’s start. It’s a good question, what is croup. The medical term for it is Laryngotracheobronchitis and to break that all down, it’s an acute inflammation of the larynx which is a voice box. The tracheo, which is a wind pipe and with the bronchi which are the main big bronching airways. What happens is those areas get swollen with the viral infection, and then when you breathing because the air is a narrow you make breathing in sound that sort of -- which is quite recognizable sound, you might have heard in children with it. Also, what we also get because that the larynx is swollen inflamed, you get a barking sea line like cough and it’s really, really distinct cough, it’s one of those cough, which I get in friends phoning me at night and say, listen to my child, they put the phone next to the child and I can diagnose over the phone that is croup. Wendy Turner: Is that distinct? Dr. Su Laurent: Now this baby does not sound like he has croup because croup is not something you get right from the very beginning, it’s an acute infection, and then it goes away again. So, this baby may actually have a little sort of -- what we call a floppy larynx and the floppy larynx is when the voice box; instead of being very close together with little flaps that close every time you breathing in and out, sometimes it’s just a little bit floppy, so every time the baby breathes in the baby will get, and when that agitated up set, it becomes much louder. Sometimes it disappears and sometimes it reappears and that is a condition floppy larynx or laryngeal Malaysia, which babies tend to out grow, but it always worth getting your baby checked out by your doctor just have a little listen to the chest and make sure about what it is and to be assure. Wendy Turner: If it was a case of croup, how long does a croup last long? Dr. Su Laurent: Croup usually lasts for few days and they usually are in older children, it’s very unusual to see croup in the baby of two weeks old. Very unusual. Wendy Turner: They definitely need medications. Dr. Su Laurent: Well, with croup you don’t need medication for the vast majority of them, vast majority of them. The GP will see them and will say that’s croup, and yes, steaming might help a little bit and usually it just gets better by itself. If a child with croup is very distressed or a baby and they come to casualty, we can actually get them steroids now, which is very successful which using the inflammation and very basic children outstaying in hospital. Wendy Turner: Yes, actually, I’m trying steam treatment, but nothing is helping. What will steam treatment do that? Dr. Su Laurent: Well, if you’re breathing very dry air and you’ve got very swollen voice box, it actually is even harder to breath. So, if the air is moist, it makes it easier to breathe in all sorts of conditions in your throat. So traditionally, we’ve always or get into a steamy bathroom and try that -- Wendy Turner: Tall of your head. Dr. Su Laurent: Tall of your head that kind of thing. Obviously being very careful with boiling water around small children and some people will find that’s very helpful, but it isn’t always very helpful and usually time is a great healer. Wendy Turner: -- Dr. Su Laurent: Exactly, exactly, exactly. Wendy Turner: Okay, and about a picky heater 17 months old needs very picky, hardly eats a decent meal just grace these all day. How can I encourage him to eat more, so he is 17 months old? Dr. Su Laurent: This is a really, really common problem and children tend to -- getting to very bad eating habits and it’s party awful because babies are often will whenever we give them, they just open their mouth, we just shovel it all in, and then they reach a face where they start turning away and saying no actually savory or whatever it is, I really only want that sweet or that salt things because very strong flavors are what babies like. Before we know, you’ve got a baby who is not eating, who is only gracing, we feed them with biscuits and crisps and all sorts of things and I can’t tell you how you would get brought to me, but parents say, my child won’t eat and through out the consultation of eating a packet of -- I mean it’s a classic thing. So, what should you do, start by going right back to basic three meals a day and no snacks, you should eat with your child and you should eat the same thing as your child’s and get your child to do that out eating. The worst thing is to make them eat, force them to eat because the more you force the child to eat, the more you’re going to get, and then turn away. Wendy Turner: Yes. Dr. Su Laurent: You have no idea, I have parents using and have them behind to safer popping out with spoon to try and catch them. Wendy Turner: Oh, wow! Dr. Su Laurent: Well, they come around the other way. I’ve one of junior doctor said that her mother continued to feed her with the spoon until she was 17 because she was so worried about her eating habits. Wendy Turner: Oh, god. Dr. Su Laurent: So, it’s really, really important to just make meals just part of every day life, you eat and if your child doesn’t want to eat, you say, fine, that’s okay, but you don’t have any more, but we will have anything else until the next meal. Don’t pull them up with milk because milk has lots of calories and will make them feel satisfied. Wendy Turner: Milk acholic. Dr. Su Laurent: You told that milk acholics. Wendy Turner: Yes. Dr. Su Laurent: So, make sure you just keep just three cents of meals a day, if they don’t want them, you just leave them, and then next meal you bring out something new, but you always make sure you don’t get them snacks in between and very soon you can switch your child to be an eater. Wendy Turner: Brilliant advice. Thank you very much. So, many questions, not enough time. Thanks Su for coming todays show. Dr. Su Laurent: Okay. Thank you very much. Wendy Turner: Thank you. Dr. Su Laurent: Bye.