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Baby Walkers

by Guest
Posted August 4 2010 02:49pm

On April 7, 2004, Canada became the first country in the world to ban the sale, advertising and import of baby walkers. It is also illegal in Canada to sell baby walkers at garage sales, flea markets or on street corners.
 
Falls down stairs in baby walkers were the greatest cause of serious head injuries for Canadian children under the age of two. Furthermore, babies in walkers can move quickly, run into hidden dangers, bump into furniture or pull on hanging appliance cords and tip over. For these reasons baby walkers have been prohibited.

Health Canada and Parents 2 Parents recommend that if you have a baby walker, you destroy it. Throw it away so it cannot be used again. It is illegal.

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The APGAR Test

by Guest
Posted August 25 2010 10:27am

The APGAR test is an early assessment of the state of your baby’s health and ability to adapt to life outside the womb. The APGAR is based on these five signs:

1.    Appearance (colour)
2.    Heart rate
3.    Breathing
4.    Muscle tone (activity)
5.    Reflex irritability (response to stimulation)

 

Each of these signs will be assigned a score of 0, 1 or 2. The maximum possible score is 10 (or 2 points for each of the five signs). The score indicates your newborn’s adjustment to the world, and whether there is a need for the medical team to intervene to help your baby along.

Score    Outcome
7-10      No difficulty in your newborn’s adjustment
4-6        Moderate difficulty
0-3        Severe distress

 

The APGAR test is given at 1 minute after birth, and again at 5 minutes after birth. Because the test must be performed immediately following birth, it’s often performed while the baby is resting on Mom’s chest. That way, there is no interruption while Mom and baby bond.

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Bassinets

by Guest
Posted August 4 2010 02:50pm

A bassinet is a basket-like product intended to provide a sleeping place for an infant. Bassinets are often made of wicker. They may also have soft or rigid sides. The Canadian Paediatric Society recommends that the safest place for a baby to sleep is on their back in a crib that meets current Canadian safety standards in their parents room.  If you choose to use a bassinet, Health Canada is proposing new standards related to their safety, check for these before purchasing a bassinet.
 
Bassinets are smaller than cribs, so are typically made for babies up to the age of 3 months old and weighing 10 kg (22 lbs) or less. Bassinets are also no larger than 50 cm (20 inches) in width and 90 cm (35 inches) in length. Whereas cradles rock back and forth, bassinets are stationary. Some bassinets come with portable frames and wheels, allowing them to be rolled from room to room. Some bassinets also come with integrated changing tables.
 
Choosing a safe bassinet:    
 

  • Choose a bassinet that is sturdy and has a wide base.
  • Choose a bassinet with a manufacturer’s label listing when, where and by whom it was made and the name and model number.
  • Choose a bassinet with a safety label listing the warnings, in both official languages.
  • Bassinets are intended for a baby who is 3 months old or less, and who has a body mass of 10 kg (22 lbs) or less.
  • Stop using this product when your baby can roll over, push up on his hands and knees or sit up.
  • Mattresses and padding should have a firm surface and fit snugly. Only use a mattress that is long and wide enough so that the gap between the mattress and the two sides forming one corner of the bassinet is not more than 3 cm (1.18 in) when the mattress is pushed into the opposite corner of the bassinet. The mattress should be no thicker than 8 cm (3.15 in)

 
Bassinet safety:
 

  • Do lock any wheels on a portable bassinet when stationary.
  • Do lock the legs on folding models when the baby is in the bassinet. 
  • Don’t use a bassinet that has rough, sharp inside edges.
  • Check the bassinet regularly before using it for any missing or loose parts.
  • Don’t use a bassinet that has space between its slats or spindles larger than 6 cm (2 3/8 inches).
  • Place the bassinet away from windows, curtains, blind or extension cords, electrical plugs or lamps. Children can fall out of windows or get caught in cords.
  • Don’t set up your bassinet with bumper pads, comforters, soft mattresses, or stuffed toys. These can suffocate your baby.
  • Don’t tie your baby in the bassinet. Strings and ribbons can choke your child.

 

Additional Resource:

Health Canada website on Safe Sleeping for Children

 

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Circumcision: What You Need to Know

by Guest
Posted August 25 2010 11:42am

If you have a baby boy, will you have him circumcised? It’s a big decision for every parent —sometimes based in religious or cultural reasons, sometimes chosen for medical reasons and sometimes based on personal preference. And it’s all wrapped up in your loving concern for the welfare and comfort of your baby. Even if you don’t know the gender of your baby yet, you may want to give this matter some thought now. There is a lot to consider before making your decision.

Circumcision is the surgical removal of the foreskin, the layer of skin that covers the head of the penis. The following information will help get you up to speed on what the research says, and what is involved in circumcising a boy’s penis.

What do expert physicians recommend and why?

  • Both the Canadian Pediatric Society and the American Academy of Pediatrics conclude that for pediatricians practicing in Canada and the United States there is currently no reason to circumcise healthy newborn males.
  • They conclude that for such boys, the medical and health risks associated with the circumcision procedure outweigh the benefits.

Why do some parents choose circumcision?

  • Some parents choose circumcision because they believe a circumcised penis is easier to keep clean.
  • Some parents choose circumcision for religious or cultural reasons. 
  • Some parents choose circumcision for personal reasons, for example, “to look like Dad or other boys.”

How is circumcision done?

Circumcision is done in many different ways. In all methods, care is taken to protect and not harm the head of the penis. Nearly all physicians and religious leaders begin circumcision by providing anesthesia. 

Here are the 3 most common ways circumcision is done. Ask your child’s doctor which method s/he will use.

  • Gomco clamp - This is the most common method used. The foreskin is retracted and a protective cover is placed over the head of the penis. The foreskin is then pulled forward over the head of the penis and a Gomco clamp is placed over the foreskin and tightened; the clamp is left on the foreskin for up to 5 minutes. During this time the pressure of the clamp cuts the foreskin and it is removed.
  • Mogen clamp - The doctor lifts the foreskin forward. This causes the head of the penis to retract towards the scrotum. A clamp is attached to protect the head of the penis, and the stretched foreskin is cut. The clamp is left on the penis to seal any bleeding. This method is frequently described as appearing less painful to the baby than the other methods.
  • Plastibell - The foreskin is stretched over a disposable plastic cap that covers the head of the penis. A string is tied around the base of the head of the penis. This causes pressure on the foreskin and the skin dies and is shed along with the plastic cap. (This may take up to a week to shed. No scalpels are used in this method.)

What are the risks or disadvantages of circumcision?

The Canadian Pediatric Society website provides the most complete information about the risks or disadvantages of circumcision. Here are the major ones:

  • Complications – The most common complications are bleeding or infection at the site of the circumcision. In Canada, the Canadian Paediatric Society reports that of every 1,000 boys who are circumcised, 20 to 30 will have a surgical complication of this type.
  • Less common complications may include difficulty peeing, removing too much tissue, prominent scarring, infection in the blood (sepsis) and reaction to the anesthetics or pain relief measures used (for example, nausea and vomiting, itching, rash). 
  • Pain - Many studies show that circumcision is very painful for babies. 
  • Cost - newborn circumcision is no longer covered by the Ontario Health Insurance Plan (OHIP). Therefore, parents must pay the cost of the procedure. Prices vary among hospitals, clinics, doctor’s offices and the health care provider that does the circumcision.

What are the benefits?

Research shows there are some benefits to circumcision. However, medical experts consider these benefits are very small compared to the risks identified above at this time, which is why the Canadian Pediatric Society and the American Academy of Pediatrics do not recommend circumcision as a routine procedure for pediatricians practicing in Canada and the United States.

The information below summarizes some of these benefits:

  • Prevention of Urinary Tract Infections (UTI) - At one time, circumcision was used to prevent these infections. However, research shows that UTI’s in males are more often due to deformities of the penis and urinary tract (such as narrow urethra or non-normal opening, which can result in an increased likelihood of infection). It is less often due to the having a foreskin cover the head of the penis. UTI’s are easily treated with antibiotics. For every 1,000 boys who are circumcised 2 will be admitted to hospital at some point in their lives for UTIs compared to 7 boys who are not circumcised.1
  • Prevention of penile cancer later in life - penile cancer is rare; 1 man in 100,000. The risk for penile cancer is slightly lower in circumcised men. 2
  • Prevention of HIV/Aids – in populations that have high rates of HIV/Aids, circumcised males are less likely to contract the disease and transmit the infection to their partners. 
  • Hygiene – It is a myth that an uncircumcised penis is less clean than a circumcised penis. Furthermore, it is equally easy to teach circumcised and uncircumcised boys how to wash their penis.

Is circumcision painful?

Many studies show that circumcision is painful for babies. There may still be some hospitals, doctors or religious leaders who do not use anesthesia when performing newborn circumcision.

However, most people who perform circumcisions may use one of the following pain relief measures:

  • Anesthetic cream (EMLA)
  • Local anesthetic injection that freezes the foreskin before it is removed. These include:
  • A subpubic ring block
  • Dorsal Penile Nerve Block (DPNB)
  • Concentrated oral sucrose solution used in combination with other types of pain relief to adequately relieve pain. Research has shown that when babies taste something sweet, they do not feel pain as intensely.

It is important for you to ask your healthcare provider or religious leader about the pain relief measures available for your son. They may not offer this information to you, if you don’t ask.

What can you do to make your baby boy more comfortable during circumcision?

  • Mom, breastfeed immediately before and after the procedure; this may help for two reasons. First, breast milk has sucrose, which tastes sweet, and when babies taste something sweet, they do not feel pain as intensely. And, of course, breastfeeding is very soothing to babies, which is what they need the most after circumcision.
  • Allow your baby to suck on a pacifier during the procedure. Sucking is soothing to babies and may reduce the pain sensation.
  • Place your baby in skin-to-skin contact against your chest. You can cover the both of you with a blanket, or better yet wear a large man’s shirt, place your baby in their diaper against your chest and then button up the shirt. Research shows that skin to skin contact can help babies regulate their temperature and help to stabilize their breathing and heart rate. 
  • Ask your doctor to prescribe a suitable type and amount of pain relief medication for your baby, to be administered after the local anesthetic wears off.

References
1.   Canadian Pediatric Society. Circumcision: Information for Parents Retrieved
2.   Circumcision Information Resource Centre. Circumcision Fact Sheet Retrieved , 2004

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