Ask Dr. Amy [12/16/19]

Hello friends,

We are wishing you all a calm and restful last weekend before the holidays are in full swing. We are busy wrapping gifts and making Kinder boxes in anticipation for our launch on 1/1/2020. But stealing a few moments now to share our answers from this week’s Ask Dr. Amy Instagram Questions.

1. Is it true that open mouth breathing is NEVER normal in babies and kids? A: Not true at all! In fact, kids are often mouth breathers (small nasal passages often get blocked, by amniotic fluid for babies, or congestion from viruses in toddlers). It’s not normal, however, to ONLY be able to breathe through the mouth. That might look like: turning blue or popping off with EVERY feed; having difficulty breathing (using extra muscles, straining to breathe); chronic congestion with face/sinus pain).

2. Can vomiting be caused by teething? 7 month old baby? A: Hmm...yes and no. Teething can cause a lot of drooling/saliva, increasing volume of spitting up (passive flow out of mouth), but it shouldn’t cause vomiting (with force, hits the wall instead of flows out passively). Teething can also cause a slight elevation in temperature but shouldn’t cause a true and sustained fever. So while it may feel like they’re vomiting because so much spitting up is happening, if there is true persistent vomiting and/or true fever, a virus is much more likely. P.S. It’s okay to give a dose of Tylenol for teething symptoms. If you are trying to give Tylenol or Ibuprofen and want to know the correct dose, consult Kinder’s weight based calculator. *If you are not sure whether your child should take these medications, always consult your pediatrician first.

3. How much water does a 9 month old need while eating 3x/day? Still breastfeeding 4x/day A: Water needs vary a lot based on activity level, temperature, metabolism, other intake, etc. So rather than aiming for a specific quantity of water, I like to use a more all-inclusive metric: urine! They should make urine at least 4-5 times a day, and the color should be clear to slightly yellow, never dark. *Take note if a kid is suddenly drinking/eating/peeing a lot more than usual, and is losing weight.

4. 12 weeks old (8 adjusted) and still not regularly lifting head. Concerning? A: My first question would be: how much tummy time is she/he doing? The #1 reason for slow head control is not enough practice. Yes, put them on the back to sleep, but while you are both awake and you are watching, have them work out with tummy time! They might not like it especially in the beginning, just like we resist working out at the gym! If you are doing tummy time and still not getting better head control, please ask your pediatrician. One objective standard is we want the head to come straight off the table when baby is pulled up by the arms by 4 months.

5. I just started my 2nd trimester and my future pediatrician said to make a prenatal appointment in the 3rd trimester. When should I go in and what should I ask for? A: I feel so strongly about this topic that I wrote a whole blog entry to answer. The gist is I think you can’t start too early to start developing a long term game plan together!