Newborn infant

Child Car Safety

When your child leaves the hospital, his or her first car ride should be a safe ride in an infant car seat. The nurses at the hospital will help you make sure your infant is properly restrained prior to leaving the hospital. 

If you need help in selecting a proper infant car seat for your child, call our office during regular office hours. The infant car seat should usually be a convertible seat, which may be used in both rear-facing and forward-facing positions. It is designed to accommodate infants and young children as they grow. The infant car seat should be positioned reclined, in the back seat of the automobile and set in the rear-facing position. 

Please note that automobile seats equipped with airbags are particularly dangerous for small infants and young children. There have been reports of infant deaths resulting from airbags deploying in minor traffic accidents where no injuries would have been expected to occur. The infant car seat should never be placed in an automobile seat which is equipped with an airbag. Instead, the infant car seat should always be placed in the back seat of the vehicle where there are no air-bags and secured using seat belts and/ or safety straps that are supplied with the infant car seat. 

Children should be placed in appropriate car seats or booster seats that are correctly installed and secured according to the manufacturer’s instructions. 

Prevention of Sudden Unexpected Infant Death (SUID)

The term “Sudden Unexpected Infant Death” (SUID) refers to any sudden and unexpected death in babies under one year of age where the cause is not immediately clear. SUID encompasses several categories, including Sudden Infant Death Syndrome (SIDS), which is a specific type of SUID. SIDS occurs when a baby under one year old dies suddenly and unexpectedly, and the cause remains unknown after a thorough investigation. These deaths typically occur during sleep or in the sleep environment. Preventing SUID is an important aspect of caring for young infants. Preventative measures include:

1. Sleep Position: Back to Sleep. Always place infants on their backs for sleep; this position doesn't increase choking risks. If they roll onto their side or stomach by themselves, it's safe to leave them there. Make sure all caregivers understand this information clearly as sleep recommendations have changed over the years.
2. Provide a Safe Sleeping Environment:

• Use a firm, level surface like a crib, bassinet, or play yard with a fitted crib sheet. Put nothing between the mattress and the fitted sheet. Keep side rails up when unattended, avoid crib bumpers, and ensure slats are no more than 2-3/8 inches apart.
• Keep the crib free from soft items such as pillows, blankets, and toys until the infant is 12 months old. Do not cover an infant with a loose blanket. Keep toys and small objects out of the crib. They are dangerous.
• Swaddling (wrapping a light blanket snugly around a baby) may help calm a crying baby. This is an acceptable practice for the first two to three months of an infant’s life. However, you should stop swaddling your baby as soon as they show signs of trying to roll over.
• Have some "Tummy Time" while your infant is awake and in your direct supervision. Place them on their tummy while they are awake and interact with them. This strengthens neck muscles and is recommended. Then, promptly put them on their back to sleep.
• Avoid Unsafe Accessories: Items like wedges, positioners, and special mattresses don't reduce SUID risk and aren't recommended.
• Sleep Locations: Avoid sleeping with the infant on couches, armchairs, or in swings. Keep cribs/bassinets within reach of your bed for convenience and safety.
• Product Safety: Ensure infant sleep products meet Consumer Product Safety Commission (CPSC) standards (www.cpsc.gov) and haven't been recalled. Avoid broken cribs or those with drop-side rails.
• Temperature & Clothing: Dress infants in light fabrics like cotton. Room temperatures should be 68-72°F (20-22°C), comfortable for a lightly clothed adult. Infants should wear no more than one extra layer than an adult would find comfortable. Use wearable blankets instead of loose bedding, and avoid baby caps except right after birth in the newborn nursery. Overheating is a known risk factor for Sudden Infant Death Syndrome (SIDS).
• Room Sharing vs. Bed Sharing: Practice room sharing by keeping the crib in your room for the first 6-12 months. Avoid bed sharing, especially if the parent(s) are smoking, using substances, or overly fatigued.
• Breastfeeding Benefits: Breastfeeding reduces SUID risk; it recommended as the sole of nutrition for the first 4-6 months and then continuing with solids until at least one year. WHO suggests breastfeeding until two years.
• Avoid Smoke Exposure: Maintain a smoke-free environment. Smoking during or after pregnancy increases SUID risks. Attempt to quit and keep smoke away from your baby, even when outside.
• Cardiorespiratory Monitors: These haven't been shown to decrease SIDS risk and are not recommended.
  

Other Safety measures needed for babies:

1. Never leave your infant alone with young siblings or pets.
2. Your water heater thermostat should be set at 120 degrees Fahrenheit or less. This is a little below the normal setting. You should be able to hold your hand momentarily under the faucet with the hot water on without scalding.
3. Never leave your infant alone or unattended on a bed or other surface from which he/she may roll off even for a brief second. Severe injuries may result.
4. Never leave your infant alone in a car, even briefly. It’s easy to become distracted, especially in the summertime, when an infant left in a hot vehicle can die from overheating. Rear-facing car seats can inadvertently contribute to this risk due to reduced visibility. To mitigate this, experts recommend strategies like placing essential items (e.g., a purse) in the back seat as a reminder, setting phone alerts, establishing check-in routines with another trusted adult, and using technologies designed to prevent these oversights.
5. Do not shake or jiggle your baby’s head. Severe brain bleeding and brain damage including death may result from shaking your baby. The “shaken baby syndrome” is a well recognized form of child abuse.
6. Baby-sitters should be carefully selected.
7. Infant jewelry such as earrings, necklaces, rings or other types of jewelry are not recommended. These items can catch on various objects and injure or even kill your child from strangulation. We do realize that some cultures value infant jewelry. However, the risk of strangulation is still present with the wearing of necklaces. Therefore, we do not recommend this practice because of the risk of strangulation.
8. Do not drink hot liquids or smoke cigarettes while holding your child because you could burn your child.
9. If you are breastfeeding, wait until breastfeeding is well-established and your baby is gaining weight before offering a pacifier. If you are not breastfeeding, you can use a pacifier whenever you like. Avoid using pacifiers that attach to infant clothing, blankets, or stuffed toys, as these can pose a suffocation and choking risk.
10. Do not use an infant feeder to feed your child baby food or semisolid food because of the risk of choking and aspiration of food into the trachea.
11. To minimize the risk of your baby developing plagiocephaly, a condition where the back of the skull becomes flattened, make sure to vary the position of your baby’s head when they rest or sleep on their back. However, even significant flattening will resolve on its own without treatment. Do try to periodically reposition your baby’s head away from the flat spot. We generally do not recommend using infant helmets for this condition. We can monitor and discuss this during an office visit.
12. Because of the risk of sunburn, babies less than six months of age should not be exposed to direct sunlight for more than just a few minutes. Instead, keep your baby in the shade. When sun exposure is unavoidable, you can apply a minimal amount of sunscreen with at least 30 to 50 SPF (sun protection factor) to small areas of your baby’s skin, such as the infant’s face and the back of the hands. We recommend Coppertone Waterbabies sunscreen 50 SPF for young children.
13. Babies and young children under two should have little to no exposure to screens such as TVs, computers, and tablets. Screens emit blue light, which may harm young children due to its short wavelength and high energy. Studies indicate that excessive screen time in young children can lead to issues like sleep disruption and may associated with certain psychiatric conditions.
14. During newborn exams at the hospital and regular check-ups in the f irst year, we check for developmental dysplasia of the hip (DDH), previously known as congenital dislocation of the hip. DDH can occur anytime in the first year, not just at birth. Risk factors include breech birth and family history. Please inform us if your baby was breech or if there's a family history of DDH. We screen for DDH at each well-child exam using specific hip maneuvers to ensure early detection and treatment.
15. While having the responsibility of caring for children, parents should avoid the use of mind-altering substances such as alcohol and/or drugs. Arkansas law is in place that protects children from parents who unwisely use mind-altering substances while caring for infants and children. The loss of the custody of a child is a life-altering tragedy that leads to profound parental regret. Please avoid this!
16. Infants and children need immunizations to prevent serious infectious diseases. Research has shown that immunizations may decrease sudden unexpected Infant death. Please see our recommended immunization and check up schedule.

New stresses for new parents:

Postpartum Depression:

The arrival of a newborn baby is a significant and often stressful event for any family. Major life changes, such as adding or losing family members, often rank among the most challenging experiences for families to navigate. Parents of newborns frequently face sleep deprivation due to repeated nighttime awakenings for needed feedings and diaper changes. This lack of sleep, combined with the stresses and trauma related to childbirth, can contribute to postpartum depression in mothers.

Following childbirth, the delivery of the placenta leads to an immediate drop in several important maternal hormones, including estrogen, progesterone, corticotropin-releasing hormone (CRH), and brain-derived neurotrophic factor (BDNF). The sudden decrease in these hormone levels can be a factor in triggering postpartum depression, leaving mothers feeling overwhelmed, sad, depressed, and unable to cope with the demands of caring for a newborn baby.

Symptoms may include an overwhelming desire to escape the stressful situation, deep fatigue, and a sense of despair that renders even basic tasks difficult. Some mothers may also feel a profound sense of detachment from their baby, combined with guilt for not wanting to engage with their child’s needs. It is important to acknowledge these feelings and seek professional help, as postpartum depression is a very treatable condition. Mothers deserve compassionate support to help them regain their well-being and enjoy their new role as a mother. A good place to begin treatment for a mother with postpartum depression is with their obstetrician. We do screen mothers for postpartum depression in our first few visits with a new baby. We refer patients with postpartum depression back to their obstetrician for care.

Shaken Baby Syndrome:

The stress of raising a new baby can lead to significant frustration and even anger in both parents, but especially in fathers. Sleep deprivation and a crying fussy baby can become just too much to take, resulting in shaking the baby in frustration in an inappropriate attempt to stop the baby’s crying. About 60 to 70% of brain injuries due to the Shaken Baby Syndrome are done by men. If frustration begins to rise in either parent while caring for your baby, never ever shake your baby. Severe head injuries and tragically, even death can result. This can be a dual tragedy, the death of the baby and legal charges for the parent(s).

Seek the help of a grandparent, family member or friend to help calm the frustration. Raising a baby is a tough job! This can help with stress management and developing nonviolent coping strategies. We, at All For Kids can also render help to frustrated, tired, sleep deprived parents in an office visit. When depressed, overwhelmed or frustrated at the birth of a new baby, please get help! We are here for you.