New Moms 101

Baby's Health And Growth

As baby grows, it's helpful to be prepared for illness, emergencies, and promoting your baby's healthy growth through immunizations.

Fever

It's reassuring to know that fevers in healthy children usually are not a sign of anything serious. In fact, it's often the body's way of fighting infections. But you should still monitor a fever closely, especially a high fever, which can make your baby fussy and uncomfortable and lead to problems like dehydration.

Fevers: What You Need to Know

• A normal temperature is around 37°C. It's usually a little lower in the morning and a little higher in the evening.
• A fever is the body's way of raising its internal temperature to fight an infection or illness.
• To monitor your baby's temperature, you'll need to learn to use a thermometer.

Taking Your Baby's Temperature

Make sure you carefully read the instructions that came with your thermometer. For safety reasons and to make sure the thermometer stays in place, never leave your baby unattended while you're taking his or her temperature. The Canadian Paediatric Society recommends the following steps:

The right method depends on your child’s age. It’s important that the measurement is accurate. For instance, taking a rectal temperature is still the best way to get an exact reading for children under 2 years of age. Although taking a temperature under the armpit isn't as reliable, it may let you know whether your child has a fever.

Age	Recommended
Birth to 2 years	1st choice: 2nd choice:
Between 2 and 5 years	1st choice: 2nd choice:
Older than 5 years	1st choice:  2nd choice:Â

Temperature-taking tips

Do not use a mercury thermometer. If it breaks, you might be exposed to this toxic substance. 

Do not use an oral thermometer to take a rectal temperature, or a rectal thermometer for oral temperature taking.

A digital thermometer can be used for both rectal and oral temperature taking. It is made of unbreakable plastic, is easy to read and measures temperature quickly.

Ear thermometers are expensive and can be complicated to use.

Fever strips are not recommended because they do not give accurate readings.

To get an accurate reading of your child’s temperature, you’ll need to make sure it’s done right. Here’s how:

Rectum

This method is the most reliable way to ensure a fever is not missed.

Clean the thermometer with cool, soapy water and rinse.

Cover the silver tip with petroleum jelly (such as Vaseline).

Place your baby on his back with his knees bent.

Gently insert the thermometer in the rectum, about 2.5 cm (1 inch), holding it in place with your fingers.

After about 1 minute, you will hear the "beep."

Remove the thermometer and read the temperature.

Clean the thermometer.

Mouth

The mouth (oral) method is not recommended for children younger than 5 years old, because it is hard for them to hold the thermometer still under their tongue for long enough.

Clean the thermometer with cool, soapy water and rinse.

Carefully place the tip of the thermometer under your child’s tongue.

With your child’s mouth closed, leave the thermometer in place for about 1 minute, until you hear the “beep.�?

Remove the thermometer and read the temperature.

Clean the thermometer.

Armpit

The armpit (axillary) method is usually used to check for fever in newborns and young children but is not as accurate as a rectal temperature. If an axillary temperature does not identify a fever but your child feels warm and seems unwell, confirm the temperature with a rectal measurement.

Use a rectal or oral thermometer.

Clean the thermometer with cool, soapy water and rinse.

Place the tip of the thermometer in the centre of the armpit.

Make sure your child’s arm is tucked snugly against her body.

Leave the thermometer in place for about 1 minute, until you hear the "beep."

Remove the thermometer and read the temperature.

Clean the thermometer.

Ear

Though quick to use, the ear (tympanic) method can produce temperature readings that are too low, even when manufacturer’s directions are followed. It is not considered to be as reliable or accurate as rectal temperature taking.

Use a clean probe tip each time, and follow the manufacturer’s instructions carefully.

Gently tug on the ear, pulling it back. This will help straighten the ear canal, and make a clear path inside the ear to the ear drum.

Gently insert the thermometer until the ear canal is fully sealed off.

Squeeze and hold down the button for one second.

Remove the thermometer and read the temperature.

Treating a Fever

If you decide to give your baby medication to treat a fever, use the following guidelines, or talk to your healthcare provider. In all cases, carefully read the dosage information on the label.

• Up to 6 months: use children's acetaminophen (like Tylenol^®).
• If your child is age 6 months or older, you may use either children's acetaminophen or children's ibuprofen (such as Advil^®, Motrin^®, others)
• Never use aspirin to treat a fever in anyone age 18 years or younger.

If your child is older than age 1 and is drinking plenty of fluids, sleeping well and acting normally, it is not usually necessary to treat a fever.

When to Call Your Healthcare Provider

Call your healthcare provider if your baby:

• Is younger than age 3 months and has a rectal temperature of 38°C or higher
• Is older than age 3 months and:
  • Has a temperature of up to 39°C and seems unusually irritable, lethargic or uncomfortable, or
  • Has a temperature of 39°C or higher that doesn't respond to over-the-counter medication or lasts longer than one day

Common Cold/"The Sniffles"

If your baby has a cold, the first symptoms will be congestion and runny nose. Additional symptoms can include:

• Nasal discharge that may start out clear, then become thicker and turns yellow or green
• A low-grade fever of about 38°C
• Sneezing
• Coughing
• Decreased appetite
• Irritability
• Difficulty sleeping

Treating a Cold

If your baby has a cold, it is important to that her or she drinks plenty of fluids. You should also keep the air moist. Normally, your baby's immune system will fight off the cold within one week to 10 days.

Never give cold medicine to your baby before checking with your healthcare provider, and never give aspirin to a child with a cold.

When To Call a Healthcare Provider

If your baby under 3 months of age, call your healthcare provider right away if you suspect a cold. Very young infants are at greater risk of complications like croup or pneumonia.

If your baby is older than 3 months, monitor his/her progress and call the healthcare provider if your baby:

• Isn't having as many wet diapers as usual
• Has a temperature higher than 39°F for one day
• Has a temperature higher than 38°C for more than three days
• Seems to have ear pain
• Has red eyes or develops yellow eye discharge
• Has a cough for more than one week
• Has thick, green nasal discharge for more than two weeks
• Is showing other symptoms that you are concerned about

Take your baby to a healthcare provider immediately if he or she:

• Coughs hard enough to cause vomiting or changes in skin color
• Coughs up blood-tinged sputum
• Refuses to nurse or accept fluids
• Has difficulty breathing or is bluish around the lips and mouth

Ear Infections

Ear infections are very common among babies and young children. Depending on the type of ear infection your child has, it may or may not require medication.

Signs that your baby might have an ear infection include:

• Fussiness and an increased amount of crying
• Fever
• If your baby pulls or grabs at his or her ear, in combination with other signs
• Diarrhea and/or loss of appetite
• Yellowish or whitish fluid draining from your baby's ear
• An unpleasant odor coming from the ear

Treating an Ear Infection

Contact your healthcare provider if you think your baby might have an ear infection. Your baby's healthcare provider can determine which type of ear infection your might have, and what the treatment should be.

Prevention of Ear Infections

If your baby is prone to ear infections, there are some steps you can take to help reduce the likelihood of getting ear infections.

• Avoid exposing your baby to secondhand tobacco smoke.
• Limit your baby's exposure to large groups of children, which increases the risk of colds and upper respiratory infections, and in turn can lead to ear infections.
• Practice frequent and thorough hand washing (use a hand sanitizer if soap and water are not readily available.
• Keep your baby's immunizations up-to-date.

Diaper Rash

Diaper rash can be caused by continuously wet or infrequently changed diapers, diarrhea, specific foods/nutrients, medicine and using plastic pants to cover diapers, and even laundry soap or other products. It's a type of inflamed skin (dermatitis) that is bright red on your baby's bottom.

Signs of Diaper Rash

• Skin: Red, puffy and sore-looking skin on the buttocks, thighs and genitals.
• Changes in disposition: Your baby may seem uncomfortable, fuss or even cry during diaper changes or when the area is washed or touched.

Treating Diaper Rash at Home

• Change diapers frequently, and use larger-sized diapers to help prevent chafing and promote healing.
• Wash your baby's bottom with water after every diaper change. Avoid soaps and wipes with alcohol or fragrance. Gently pat your baby dry with a soft towel (don't rub), and apply a diaper rash cream or ointment (ask you healthcare provider for a recommendation) before putting on the new diaper. Talcum powder is no longer recommended to treat diaper rash, as it can irritate your baby's lungs.
• Let your baby go without a diaper as much as possible, to let the area dry out and start healing. Try laying your baby on a large towel and spending some time playing while he or she is bare-bottomed.
• Once the rash heals, consider using ointment as a moisture barrier on an ongoing basis. This can help keep your baby's skin in good, rash-free condition.
• Always wash your hands thoroughly after changing diapers.

When to Contact Your Healthcare Provider

Contact your baby's healthcare provider if the rash doesn't improve within a few days, or if your child also develops a fever, blisters, pus/discharge, or if the rash spreads beyond the diaper area. Sometimes, diaper rash can become infected and require prescription medications.

If the rash is not responding to home treatment, your healthcare provider might prescribe a medicated cream; if the rash continues, he/she may refer you to a dermatologist.

Cradle Cap

Cradle cap is the common name for infantile seborrheic dermatitis. Cradle cap is most common in newborns. It isn't contagious, and usually doesn't make babies itch.

Signs of Cradle Cap

• Patchy scaling or thick crusts on the scalp, and sometimes on ears, nose, eyelids or groin.
• Greasy skin covered with flaky white or yellow scales
• Flaky scalp
• Possibly mild redness

Treating Cradle Cap at Home

Cradle cap usually goes away on its own within a few months.

• Try washing your baby's scalp daily with a mild shampoo and brush it gently with a light brush or washcloth to help loosen and remove the scales.
• If the scales don't loosen with shampoo alone, try rubbing a bit of petroleum jelly or mineral oil onto your baby's scalp. Let it sit for a few minutes, then shampoo out gently but thoroughly.
• You can also ask your healthcare provider to recommend a medicated shampoo, lotion or other treatment, like hydrocortisone cream.

When to Contact Your Healthcare Provider

Contact your baby's healthcare provider if the scaly patches spread to your baby's face or body. Or, if the symptoms don't get better after several months, your baby could have a ringworm infection, in which case your provider will likely give you a prescription for antifungal shampoo.

Milia

Milia are most common in newborns, and consist of tiny white bumps on your baby' cheeks, chin or nose. More than half of all babies get milia.

Signs of Milia

• Tiny white bumps on cheeks, chin, nose, or sometimes upper body or arms/legs.
• Tiny white bumps on gums or the roof of your baby's mouth, known as "Epstein pearls."

Treating Milia at Home

Milia usually goes away all by itself within a few weeks. However, you can make sure to help keep your baby's skin healthy by:

• Washing your baby's face with warm water every day. Avoiding scrubbing the tiny bumps.
• Gently patting your baby's face dry with a soft towel; do not apply any lotions or creams.

When to Contact Your Healthcare Provider

If the milia don't go away within three months, ask your healthcare provider for advice.

Baby Acne

Baby acne is acne on a newborn's skin, usually the face. It is very common, especially in boys and typically develops within the first three to four weeks.

Signs of Baby Acne

• Small red bumps or "pimples" on your baby's cheeks, chin or forehead.
• Baby acne can look worse/more inflamed your baby is crying or fussing.

Treating Baby Acne at Home

Baby acne usually goes away by itself within a few weeks. No treatment is necessary. However, you can be sure to keep your baby's face clean during this time by:

• Washing your baby's face with warm water to or three times a day. You can use a very mild moisturizing soap a few times during the week (not every day). Do not squeeze or scrub the acne; this could lead to infection.
• Gently patting your baby's face, try with a soft towel; do not apply any lotions or creams.

When to Contact Your Healthcare Provider

Call your baby's healthcare provider if the baby acne doesn't go away after three months, or if it looks like it's getting worse. He/she may recommend using a medicated cream.

Heat Rash

This common rash that afflicts newborns is also known as prickly heat or "miliaria crystalline." It's the mildest form of heat rash, and it's not itchy or painful for your baby.

Signs of Heat Rash

• Small red blisters or bumps that break easily.
• On babies, it is usually on the neck, shoulders and chest, but the rash can also occur in the armpits, elbow creases or groin.

Treating Heat Rash at Home

Heat rash occurs in the top layer of skin, when sweat ducts (which aren't fully developed yet) get blocked. This can come from hot weather, too-warm clothing, or sometimes from a high fever or time spent in an incubator.

• Heat rash typically goes away on its own, and no treatment is necessary.
• It may help to keep your baby's room somewhat cool, with circulating air, and not to overdress your baby.
• Sometimes heat rash comes back with hot and humid weather conditions.

When to Contact Your Healthcare Provider

Contact your baby's healthcare provider if the rash lasts longer than a few days or seems to be getting worse. Also, call if you see a sign of an infection, such as:

• Warmth, swelling or pus around the rash area, or if your baby seems uncomfortable or itchy.

Infantile Eczema

Eczema is common in infants. It's an itchy inflammation of the skin, and is sometimes seen in a child with allergies or asthma.

Signs of Eczema

• Red patches, often behind the arms or knees

Treating Infantile Eczema at Home

Ask your healthcare provider for recommendations of which product to use to help lubricate your baby's skin. This could include bath products, creams or ointments. It may also help to avoid extreme temperatures.

When to Contact Your Healthcare Provider

Contact your baby's healthcare provider if the recommended products don't improve the skin or it looks infected (more inflamed, warm to the touch, or filled with pus). He/she may prescribe an antihistamine (allergy medication) to control the itch; antihistamines also cause drowsiness, which can help your baby sleep better if he or she is uncomfortable or itchy.

Immunization

It's important to protect your baby's health against the harmful effects of some diseases by making sure he or she gets timely immunizations. Immunization uses vaccines to stimulate the body to produce antibodies; these antibodies, in turn protect your growing child against getting specific diseases.

About Immunization:

Vaccines are safe, with huge benefits to children's health- all through their lives. Vaccines in Canada are effective and safe--much safer than the 13 diseases they prevent. These diseases can lead to pneumonia, deafness, brain damage, heart problems, blindness, paralysis and carry a risk of life-long disability or death.

Severe reactions from vaccines are extremely rare and are reported immediately to the Public Health Agency of Canada so that any problems can be dealt with quickly.

• Before immunization became widespread, children were vulnerable to serious diseases that often resulted in death or disability. Infections also meant time away from school for children, or lost time at work and much distress for parents.
• Today, the diseases that immunizations protect against are held in check by immunizations. Because of this, it is now rare for a child in Canada to get diseases like diphtheria, polio, or tetanus.
• In addition, measles, whooping cough, mumps, and rubella are becoming less common as more and more children are immunized. Without immunization, these diseases can and do cause outbreaks in communities across the country.

Once in use, vaccines are continually monitored for safety and efficacy. Ask your baby's healthcare provider any questions you might have about immunizations.

For access to the most current childhood immunization schedules by province and territory for children under 6 years of age, visit the “Your immunization schedule�? page of the Public Health Agency of Canada website at: