A description of a baby whose muscles lack normal tension or tone (see hypotonia in infants).
Possible risk factors include: laying the baby face-down to sleep; overheating; parental smoking after the birth; prematurity and low birth weight; and poor socioeconomic background.
Preventive measures include: ensuring that the baby sleeps on its back at the foot of the cot; regulating the baby’s temperature (using the same amount of clothing and blankets that an adult would need); and stopping smoking.... sudden infant death syndrome
Breast feeding Unless there is a genuine contraindication, every baby should be breast fed. The nutritional components of human milk are in the ideal proportions to promote the healthy growth of the human newborn. The mother’s milk, especially colostrum (the ?uid secreted before full lactation is established) contains immune cells and antibodies that increase the baby’s resistance to infection. From the mother’s point of view, breast feeding helps the womb to return to its normal size and helps her to lose excess body fat gained during pregnancy. Most importantly, breast feeding promotes intimate contact between mother and baby. A ?nal point to be borne in mind, however, is that drugs taken by a mother can be excreted in her milk. These include antibiotics, sedatives, tranquillisers, alcohol, nicotine and high-dose steroids or vitamins. Fortunately this is rarely a cause of trouble. (See also main entry on BREAST FEEDING.)
Arti?cial feeding Unmodi?ed cows’ milk is not a satisfactory food for the human newborn and may cause dangerous metabolic imbalance. If breast feeding is not feasible, one of the many commerciallly available formula milks should be used. Most of these are made from cows’ milk which has been modi?ed to re?ect the composition of human milk as closely as possible. For the rare infant who develops cows’-milk-protein intolerance, a milk based on soya-bean protein is indicated.
Feeding and weight gain The main guide as to whether an infant is being adequately fed is the weight. During the ?rst days of life a healthy infant loses weight, but should by the end of the second week return to birth weight. From then on, weight gain should be approximately 6oz. (170g) each week.
The timing of feeds reffects social convention rather than natural feeding patterns. Among the most primitive hunter-gatherer tribes of South America, babies are carried next to the breast and allowed to suckle at will. Fortunately for developed society, however, babies can be conditioned to intermittent feedings.
As the timing of breast feeding is ?exible – little or no preparation time being required – mothers can choose to feed their babies on demand. Far from spoiling the baby, demand feeding is likely to lead to a contented infant, the only necessary caution being that a crying baby is not always a hungry baby.
In general, a newborn will require feeding every two to four hours and, if well, is unlikely to sleep for more than six hours. After the ?rst months, a few lucky parents will ?nd their infant sleeping through the night.
Weaning Weaning on to solid foods is again a matter of individuality. Most babies will become dissatis?ed with a milk-only diet at around six months and develop enthusiasm for cereal-based weaning foods. Also at about this time they enjoy holding objects and transferring them to their mouths – the mouth being an important sense organ in infants. It is logical to include food items that they can hold, as this clearly brings the baby pleasure at this time. Introduction of solids before the age of four months is unusual and best avoided. The usual reason given for early weaning is that the baby appears hungry, but this is unlikely to be the case; crying due to COLIC, for example, is more probable. Some mothers take the baby’s desire to suck – say, on their ?nger – as a sign of hunger when this is, in fact, re?ex activity.
Delaying the start of weaning beyond nine months is nutritionally undesirable. As weaning progresses, the infant’s diet requires less milk. Once established on a varied solid diet, breast and formula milks can be safely replaced with cows’ milk. There is, however, no nutritional contraindication to continued breast feeding until the mother wishes to stop.
It is during weaning that infants realise they can arouse extreme maternal anxiety by refusing to eat. This can lead to force-feeding and battles of will which may culminate in a breakdown of the mother-child relationship. To avoid this, parents must resist the temptation to coax the child to eat. If the child refuses solid food, the meal should be taken away with a minimum of fuss. Children’s appetites re?ect their individual genetic structure and a well child will eat enough to grow and maintain satisfactory weight gain. If a child is not eating properly, weight gain will be inadequate over a prolonged period and an underlying illness is the most likely cause. Indeed, failure to thrive is the paediatrician’s best clue to chronic illness.
Advice on feeding Many sources of con?icting advice are available to new parents. It is impossible to satisfy everyone, and ultimately it is the well-being of the mother and infant and the closeness of their relationship that matter. In general, mothers should be wary of rigid advice. An experienced midwife, health visitor or well-baby-clinic nursing sister are among the most reliable sources of information.
Protein Fat per Sugar Calories per cent cent per cent per cent
Human milk 1·1 4·2 7·0 70 Cows’ milk 3·5 3·9 4·6 66
Composition of human and cows’ milk... infant feeding
Teas. Spearmint, Dill seeds or Roman Chamomile. 1 teaspoon to each cup boiling water infused until warm. Teaspoonful doses as necessary.
Aromatherapy. Gentle abdominal massage: 3 drops oil Chamomile in 1 teaspoon Almond oil. If not available, use warm Olive oil. ... colic, infant
A baby with an attack of colic cries or screams incessantly, draws up the legs towards the stomach, and may become red in the face and pass wind.
Colic tends to be worse in the evenings.
The condition is distressing but harmless.
Usually, it first appears at 3–4 weeks and clears up without treatment by the age of 12 weeks.... colic, infantile
The improvement in the infant mortality rate has occurred mainly in the period from the second month of life. There has been much less improvement in the neonatal mortality rate – that is, the number of infants dying during the ?rst four weeks of life, expressed as a proportion of every 1,000 live births. During the ?rst week of life the main causes of death are asphyxia, prematurity, birth injuries and congenital abnormalities. After the ?rst week the main cause of death is infection.
Social conditions also play an important role in infant mortality. In England and Wales the infant mortality rate in 1930–32 was: Social Class I (professional), 32·7; Social Class III (skilled workers), 57·6; Social Class V (unskilled workers), 77·1. Many factors come into play in producing these social variations, but overcrowding is undoubtedly one of the most important.
1838–9 146 1950–52 30 1851–60 154 1960–62 22 1900–02 142 1970–72 18 1910–12 110 1980–82 12 1920–22 82 1990–92 7 1930–32 67 1996 6·2 1940–42 59 1999 5.8 2000 5.6
It is thus evident that for a reduction of the infant mortality rate to the minimum ?gure, the following conditions must be met. Mothers and potential mothers must be housed adequately in healthy surroundings, particularly with regard to safe water supplies and sewage disposal. The pregnant and nursing mother must be ensured an adequate diet. E?ective antenatal supervision must be available to every mother, as well as skilled supervision during labour (see PREGNANCY AND LABOUR). The newborn infant must be adequately nursed and fed and mothers encouraged to breast feed. Environmental and public-health measures must be taken to ensure adequate housing, a clean milk supply and full availability of medical care including such protective measures as IMMUNISATION against diphtheria, measles, poliomyelitis and whooping-cough. (See also PERINATAL MORTALITY.)... infant mortality rate (imr)
Causes These are unknown, with possible multiple aetiology. Prematurity and low birth-weight may play a role. The sleeping position of a baby and an over-warm environment may be major factors, since deaths have fallen sharply since mothers were o?cially advised to place babies on their backs and not to overheat them. Some deaths are probably the result of respiratory infections, usually viral, which may stop breathing in at-risk infants, while others may result from the infant becoming smothered in a soft pillow. Faults in the baby’s central breathing control system (central APNOEA) may be a factor. Other possible factors include poor socioeconomic environment; vitamin E de?ciency; or smoking, drug addiction or anaemia in the mother. Help and advice may be obtained from the Foundation for the Study of Infant Deaths and the Cot Death Society.... sudden infant death syndrome (sids)
Most healthy babies stop crying when their needs are attended to.
In a few cases, persistent crying may be due to a physical cause such as intolerance of cow’s milk or an illness (such as an ear or throat infection, or a viral fever).... crying in infants
an early feature of cerebral palsy.
It occurs in disorders of the spinal cord, such as Werdnig–Hoffman disease, and in some children who have muscular dystrophy.... hypotonia in infants
Treatment. Purpose of medication is to stimulate flow of bile and support the liver.
Arthur Hyde, MNIMH recommends a selection from the following according to individual case: Balmony, Barberry, Dandelion, Goldenseal, Hops, Ladyslipper, Mistletoe, Passion flower, Stone root. Tinctures. Formula. Marigold 2; Barberry 2; Ginkgo 1. Dose: 2 drops in feed, or in water, thrice daily. Infants 3-5 years: 10 drops.
To be treated by or in liaison with a qualified medical practitioner. ... haemolytic disease of infants
During the first 4 to 6 months, most babies’ nutritional requirements are met by milk alone, whether by breast-feeding or bottle-feeding. Both human milk and artificial milk contain carbohydrate, protein, fat, vitamins, and minerals in similar proportions. However, human milk also contains antibodies and white blood cells that protect the baby against infection. From 6 weeks, supplementary vitamin D should be given to breast-fed babies. Formula milk already contains vitamin supplements.
At 1 year of age, a baby can be safely fed with full-fat cow’s milk. Vitamin supplements should then be given until the baby is established on a mixed diet. Solids, initially in the form of purees and wheat-free cereals, should be introduced between 4 and 6 months of age,depending on the birth weight, rate of growth, and contentment with feeding. By 6 months, the baby should be eating true solids, such as chopped-up meat and vegetables.
A few babies have an intolerance to certain foods such as lactose or cow’s milk protein (see food intolerance; nutritional disorders).... feeding, infant
infarction Death of an area of tissue due to ischaemia (lack of blood supply). Common examples include myocardial infarction, which is also known as heart attack, and pulmonary infarction, which is lung damage caused by a pulmonary embolism – a blood clot that has moved into a vessel in the lung and is obstructing the flow of blood. (See also necrosis.)... infant mortality
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