Thursday, March 15, 2012

Baby and Permanent Teeth Eruption Charts


 Have you ever asked yourself one of these questions?
  • When do baby teeth come in? 
  • Which tooth comes in first?
  • How is the baby teething schedule? 
  • How many teeth do babies have?
If you are a first mom, you probably have.

Even though baby teeth (primary dentition) eruption may vary from child to child, most children will have their lower central incisors (see chart below) breaking through their gum at 6 months of age followed by the upper incisors. Don't be alarmed if your baby's teeth start to come in at 4 months of age or if it doesn't start until your baby is 9 months old. As I mention before, the variation is normal.

The most common order of baby teeth eruption is:
  1. Lower central incisors
  2. Upper central and lateral incisors
  3. Lower lateral incisors
  4. First Molars
  5. Canines
  6. Second Molars
Usually:
  • They come in pairs 
  • Lower teeth erupt first
  • Girls' schedule is ahead of boys
  • Baby teeth are whiter than permanent teeth

It is also normal to have gap between the teeth in the primary dentition.


Primary Teeth Eruption Chart

IMAGE: Primary Teeth Eruption Chart
 Chart from the American Dental Association (ADA)


As you see on the chart, the primary dentition consists of 20 teeth: 8 incisors, 4 canines and 8 molars. Most children will have all 20 baby teeth by the time they are 3 years old. At around 6 years of age, the baby teeth start to shed as the permanent teeth start to erupt.

Although baby teeth are temporary, it is very important to take good care of them. They serve as a guide for the eruption of the permanent teeth; maintain the proper space for the permanent teeth; help the development of a good speech and are very important for proper nutrition.

In fact, oral care is important even before the first tooth comes in. Parents should clean the baby's gum with a soft damp cloth twice a day (mornings and before bedtime). Once the first tooth comes in, it should be brushed with a soft age appropriate sized tooth brush and water (fluoride toothpaste is not recommended for children under 2 years old) at least twice a day . Children older than 6 months may need fluoride supplement to reduce the risk of tooth decay if the local drinking water doesn't contain enough fluoride (ask your dentist).

The American Academy of Pediatric Dentistry (AAPD) recommends parents to take their children for a first dental visit no later than the child's first birthday. Prevention is the key!

It is important to mention that the first permanent teeth to erupt are the first molars (together with the lower incisors) and they come in behind the last baby teeth (baby second molars). This is important because since there is no shed, most parents tend to think they are baby teeth.


Permanent Teeth Eruption Chart

IMAGE: Permanent Teeth Eruption Chart
Chart from the American Dental Association (ADA)


There are 32 teeth in the permanent dentition: 8 incisors, 4 canines, 8 pre-molars and 12 molars. The permanent teeth eruption starts at age of 6-7 (permanent lower central incisors) and finishes at age of 17-21 (third molars).



Image Source: Photostock



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Thursday, March 8, 2012

Guest Post: Infertility Issues and a Miracle Baby

I'm happy to introduce you Tammy Hemmerling, the author of Lucky Emeralds Reviews blog.
 
In this post, Tammy shares with us her struggles with infertility, several fertilization attempts, depression, marital problems and a miracle baby. I'm sure you will love to read it as much as I did!

Thank you Tammy for sharing your beautiful story and giving hope to mothers facing infertility!


 When I was 16 years old, just a sophomore in high school, I had a terrible time with cysts on my ovaries. Polycystic Ovarian Syndrome was what my doctor told me. He also told me I would never have children. Now, that's a tough thing to hear when you're only 16 years old! By then I had already envisioned my life. I would go to college and get a degree in Early Childhood Education. While I was in college, I would meet my future husband. After college, we would get married and I would be working as a 1st or 2nd grade teacher. We would start our family right away, I was planning on 2 or 3 children at the time. But the doctor was telling me that my dream wasn't meant to be.

I went on with my life, going to college and meeting the husband. I decided to drop out of college to get married when I was 22 years old. At that point my new husband and I had talked about children and the problems that I had keeping me from having them and decided together that we would see every fertility specialist we could find until we had a child! We were very determined to have children together!

We gave it a year to try on our own, and when nothing happened, we made our first appointment with a fertility specialist that was recommended by our family doctor. When we went to that appointment, my husband and I were both tested to see who was fertile and who wasn't. I was also put through several very invasive tests to see where my problem was located. The doctor suggested we try Intrauterine Fertilization where they would take my husband's sperm and fertilize my egg inside my uterus. We tried that way 4 times over the course of 5 years. It was rather expensive for each fertilization so we were only doing one once we had saved up the money. Our only other option was In Vitro Fertilization (IVF) where the doctor took my egg and my husband's sperm and tried to join them in a petri dish to create and embryo and then implant it back into my uterus with the hope that it would stick and grow into a viable pregnancy. We tried it once and once again, it didn't work.

At that point, I gave up. I went into a deep depression and my marriage started to suffer. Eventually, after 9 years of marriage, we divorced. I went into therapy and started taking antidepressants and started to feel better. I had blamed myself for not being able to do something that women were supposed to do! Something women had been doing for hundreds of years, most of them with no problems at all! I had also unfairly blamed my now ex-husband. It was a big mistake.

Not long after my divorce, I met another man, fell in love, and married again! He knew from the start all the problems I had gone through having children and was very supportive. I had given up any hope that it would happen anyway. 3 months after we got married, I started feeling HORRIBLE! I felt like I had the stomach flu and was vomiting day and night! After a few days of feeling badly, my husband said, "What if you're pregnant?" I laughed it off and called my doctor for an appointment. At my appointment, the doctor checked me over and asked me all the routine questions, one of them being "When was your last period?" My periods have always been irregular due to the cysts so I just told her it had been a couple of months ago maybe. She decided to draw blood to test my blood count and do some other tests and sent me home with some nausea medicine.

2 days later, my doctor called me, which I thought was strange since normally her nurse would call and give me test results, not her personally! She said, "Tammy, I have your test results and I happy to tell you that you are pregnant!" I was stunned! I just stood there silent with my mouth wide open! I had to have looked like an idiot because my husband came over to me looking concerned. I thanked the doctor and hung up. Then I looked at my husband and tried to talk but nothing would come out! He started freaking out a little and made me sit down. After a few minutes, I started to cry which freaked him out even more! I looked up and choked out "I'm pregnant."  He let out a big yell and started jumping around like a madman grinning from ear to ear! All I could do was sit there and cry! My dreams had finally come true, but I wasn't out of the woods just yet. I still had to carry this baby to term! The thought of a miscarriage crossed my mind and weighed heavily from day one.

As days passed, then weeks, then months, I started to feel a little better and not be so worried that I would lose the baby. I started to enjoy being pregnant! I ate anything I craved without worrying about calories! I enjoyed when my husband would rub my belly and try to talk to the baby through my belly button. As my belly grew, and I felt those little flutters and then big kicks, I was so happy and started buying unisex clothes and blankets. I had my first ultrasound at 20 weeks because they considered this a high-risk pregnancy due to my history of infertility and also my age. I was 33 years old at this point. That was when we heard our baby's heartbeat for the first time. We were ecstatic when we heard it and we left the office crying tears of happiness! I was doing great and the baby too! At 26 weeks, we had another ultrasound and found out we were definitely having a boy! He wasn't shy at all and gladly showed us what he was! LOL Life was great!

A week later, my husband was at work and I was at home resting and watching some TV when I started feeling pains in my back and left side. It was like a cramping pain and over the course of a few hours, the pains got unbearable! It would come and go every few minutes and with me being a first time mom, I had no clue what it could be! I called my doctor and she told me to go to the emergency room at our local hospital and she would meet me there. I had a friend come pick me up and headed to the hospital. After I was examined, the doctor said she was pretty sure I was in pre-term labor and we needed to get it stopped with some medicine. I was admitted and had an IV started. They started giving me a medicine called Terbutaline. It's supposed to stop pre-term labor. By this time, my husband and mom had gotten to the hospital. I was almost inconsolable. This was what I had worried about for so long! It was happening! What if they couldn't stop my labor and my son would have to be born at 27 weeks??? I just couldn't fathom the thought at that point! I knew it wouldn't be good for him to be born that early! I ended up having to stay in the hospital for 5 days on the medicine. It wasn't pleasant at all. Terbutaline has strange side effects. It made me very jittery. I trembled all over and had hot flashes all the time. It made it almost impossible to sleep so by the time I was able to go home, I was exhausted! Once I went home, I was taken off the medicine and everything was fine! For about 2 weeks that is. I went into pre-term labor AGAIN! This time I was in the hospital for almost 2 weeks! I was 30 weeks along at that point.

Over the next 5 weeks I was in and out of the hospital 4 more times. It seemed that I lived there almost! I took the Lamaze classes offered at our hospital while I was in the hospital! At 35 weeks, I was home again when the labor pains started yet again! I was so tired of doing this all the time! I sent me husband off to work and made my way to the hospital yet again. My doctor arrived and it all seemed like deja vu. They did an ultrasound and realized that my son's heart rate was lower than it had been. My blood pressure was higher than it should have been. A lot higher. My doctor was concerned about pre-eclampsia. She came in and said, "Tammy, I really want to get this baby delivered today." It scared me to death because he would still be 5 weeks early, and I didn't have anyone at the hospital with me! My doctor said she wanted to do a C-section since my son's heart rate was going lower and lower. So I got on the phone and called my husband and my mom and told them to get their butts to the hospital like
NOW! I was having the baby in the next hour! You can imagine their surprise!  It was craziness in my room for the next hour! The anaesthesiologist had to do my epidural and the nurses came in and out doing their thing. My husband showed up first looking like someone had punched him in the stomach several times! My mom showed up soon after and ended up being of great comfort to me since she had 2 C-sections herself so she was very reassuring. Once I was wheeled into the operating room, things seemed to go very quickly! It was only a matter of about 10 minutes when I heard my son cry for the first time. My husband and I looked at each other when we heard it and immediately started crying. The doctor pulled the curtain down a little and showed us our son for the first time! That is a moment I will never forget. He was beautiful! The doctor handed him off to a nurse and they cleaned him up and surprisingly he was breathing very well on his own! Once they cleaned him up and swaddled him up, they brought him to me. I was still laying on the table, but the nurse placed my son right up to my cheek. I kissed and kissed him over and over and told him in a whisper, "I've waited a long time for you, and I love you to the moon and back." They let my husband hold him and it was such a beautiful sight to see my husband holding his son. All he could do was stare at his son and cry! They took our son from the room and my husband went with them. I had to stay in the operating room because the doctor found a hernia while he was delivering the baby and he wanted to go ahead and fix it. So it was almost and hour before they got me back up to my room and my husband was able to hand my baby to me to hold for the first time. At that moment I knew that everything I had gone through had been worth it. My husband and I had discussed names on and off throughout the pregnancy and when I was sitting there holding my baby, I knew what I wanted his name to be. I looked at my husband and said, "His name is Jaden Riley." We had both liked that name so he didn't argue.

All the years I had waited for this baby and all the problems and bad feelings just melted away in that hospital room with my Jaden in my arms. I was finally at peace and I have thanked God every day for this little miracle. Jaden is 4 years old now and the light of my life! I haven't even had the urge to try for another baby. At my current age of 38 I'm afraid I would be asking too much from my body. Every day since Jaden's birth and every day for the rest of my life I will tell him the same thing I told him the day he was born. "I waited a long time for you, and I love you to the moon and back."


Tammy Hemmerling
author of Lucky Emeralds Reviews




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Monday, March 5, 2012

Baby Acne


Have you ever heard someone saying "this is soft as a baby skin"? I'm sure you did.

It is true that babies have soft skin but it is also true and very common for babies to have acne after 3 to 4 weeks after they are born.

This may cause some concern for new parents. They may start to wonder if their babies are already showing some type of a skin condition. At least, this was what came to my mind when my daughter started to show some red bumps on her cheeks and forehead after a couple of weeks being home from the hospital.

Even though scientists haven't yet found the cause, they believe that there is a link between baby acne and mother's hormone. During pregnancy, babies are exposed to all of their mother's hormone that travel through the placenta. Just after birth, most babies (boys and girls) have swollen nipples and some baby girls may present swollen genitalia and a false menstruation (pink or blood-tinged discharge). After a couple of weeks later they may have acne.  These signs show that the mother's hormone are still circulating in the baby's body.

In baby acne, the mother's hormone stimulate excessive oil production, causing the clog of the immature baby's sweat glands. The symptoms are red bumps/pimples on the cheeks, forehead and chin. Sometimes whiteheads is also present.

The good news is that it is NORMAL, and it clears up by itself within a few months without any treatment.

During this time, is important to be patient and to treat the baby's face with care, washing it with a mild soap/water once daily and to not scrub it.


Tip: Some of my friends have told me that they had great results by gently applying breast milk to their babies skin.
This is not a medical recommendation, always discuss with your baby's doctor what is the best treatment!






Image Source: David Castillo Dominici





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    Sunday, February 26, 2012

    Supplementing to Exclusive Breastfeeding


     After approximately 2 weeks after delivering my daughter I started having breastfeeding complications. I was in so much pain that I just couldn't have her on my breasts, I had to start giving her the bottle. Following the recommendation I received from a lactation consultant, I rented a hospital grade breast pump to keep my supply until I was ready to breastfeed again.

    It is important to mention that not even the best breast pump stimulates the production of breast milk as a baby sucking on the breast.

    Our body is a perfect machine. The production of breast milk is proportional to demand. Every time we skip one breastfeeding or pumping session and supplement with formula, we are "telling" our body that the baby doesn't need breast milk at that time. This decreases the breast milk production.

    Even though the lactation consultant advised me to pump at every feeding session, I have to be honest and admit that I didn't do it every time. During that period when I was only giving my daughter the bottle, the amount of breast milk that I was pumping wasn't enough to satisfy her and therefore, I had to supplement with formula.

    Once I recovered from the breastfeeding complications, I wanted to go back to exclusive breastfeeding. I knew that it wouldn't be an easy process, but I was very determined to do everything I could to stop supplementing.

    One day when I was doing some research on the internet about this subject, I was lucky to come across to a VERY helpful breastfeeding internet forum (ivillage), where I could post questions/concerns and have them answered by an experienced lactation consultant.

    After some posts exchange, I learned what I had to do to wean from formula. The lactation consultant advised me to monitor my daughter's weight every week throughout the process to be sure she was getting enough milk.

    The process would have to be slow to give time to my body and my daughter to adjust to the new routine. As I mention before, the production of breast milk is proportional to demand. I had to slowly increase the demand to increase the breast milk production.

    I observed my daughter's feeding schedule and wet/dirty diaper count for a couple of days. It was important to know exactly how much formula (oz) I was giving her and how many wet/dirty diaper she had per day before starting the weaning process. I also had her weight checked. After I had all the information written down, I started by reducing 1 oz of formula per day (not per feeding) every 3 days.

    According to my notes, I was giving her approximately 24 oz of formula per day (4 oz per feeding, 6 formula feeding sessions) and having 4 - 5 breastfeeding sessions. I was also pumping just after the formula feeding sessions (as often as I could) to help increase breast milk production.

    These were the steps I followed to wean from formula feeding:
    • Step 1 (days 01 - 03): Reduction of 1 ounce of formula from one (1) feeding session and then breastfeed. All the other feeding sessions were kept the same as they used to be. I checked the number of wet diapers per day and they were the same or more than used to be, so I went ahead to step 2. Otherwise, I would have stayed couple more days on step 1.
    • Step 2 (days 04 - 06): Reduction of 1 more ounce of formula from the same feeding session and then breastfed. All the other feeding sessions were kept the same as they used to be. I checked the number of wet diapers per day and they were the same or more than used to be, so I went ahead to step 4. Otherwise, I would have stayed couple more days on step 2.
    • Step 3: After 1 week, I took her to a local breastfeeding class and had her weight checked to make sure she was getting enough milk and gaining weight. Everything was fine, so I went ahead to step 4.
    • Step 4 (days 07 - 09): I reduced 1 more ounce of formula from the same feeding session and then breastfed. All the other feeding sessions were kept the same as they used to be. I checked the number of wet diapers per day and they were the same or more than used to be, so I went ahead to step 5. Otherwise, I would have stayed couple more days on step 4.
    • Step 5 (days 10 - 12): I reduced 1 more ounce of formula from the same feeding session and then breastfed. All the other feeding sessions were kept the same as they used to be. I checked the number of wet diapers per day and they were the same or more than used to be, so I went ahead to step 6. Otherwise, I would have stayed couple more days on step 5.
    • Step 6 (days 13 - 15): I reduced 1 ounce of formula from another formula feeding session and then breastfed. All the other feeding sessions were kept the same as they used to be. I checked the number of wet diapers per day and they were the same or more than used to be, so I went ahead to step 8. Otherwise, I would have stayed couple more days on step 6. 
    • Step 7: Weight check at breastfeeding class.
    • Step 8, 9, 10, ... : Same as step 1, 2, 3, 4 and 5.

      On the 12th day I had completely reduced 4 oz of formula (1 formula feeding) and substituted by a breastfeeding session. I kept reducing 1 oz of formula every 3 day until my daughter was completely weaned from formula.

      As I mentioned above, every week I would go to a breastfeeding class to check my daughter's progress (weight and growth). During the classes, the lactation consultant would check my daughter's weight (using a very sensitive scale) before and after the breastfeeding session to check the breast milk intake. It was important to know if my breast milk production was increasing and my daughter was getting enough. Every week she would write the results down and compare them to the previous week to make sure we were doing well.

      According to Kellymom's website, the average weight gain for a breastfeeding baby should be:
      • 0 - 4 months old baby should gain 5 - 7 ounces per week 
      • 4 - 6 months old baby should gain 4 - 5 ounces per week
      • 6 - 12 months old baby should gain 2 - 4 ounces per week

        The whole process took more than 2 months. It wasn't easy, I really had to be persistent and determined, but at the end I was thrilled. I just couldn't believe my accomplishment. My daughter was healthy and growing thanks exclusively to my breast milk!

        I exclusively breastfed my daughter until she was 6 months old, as it is recommended by the American Academy of Pediatrics (AAP) and the World Health Organization (WHO), when I then started to introduce solid foods.

        I continued breastfeeding until she was 30 months old. The AAP recommends breastfeeding for at least 12 months, and thereafter for as long as mother and baby desire and the WHO recommends continued breastfeeding up to 2 years of age or beyond.




        Image source: Duron123




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        Thursday, February 16, 2012

        Breastfeeding Statistics


        About a month ago while talking to one of my friends who is a new mom and lives in Brazil, she asked me about the breastfeeding statistics here in the U.S. and how acceptable was to supplement breastfed babies with formula.

        Even though I breastfed my daughter for the first 6 months almost exclusively (I only supplemented with formula for a couple of weeks when I was having breastfeeding complications) and continued breastfeeding until she was 30 months old, I know that it is not a common thing to do. Some of my friends only breastfed for the first 3 months (supplementing with formula) and others went straight to formula without even trying to breastfeed.

        Based on my circle of friends, the large majority only breastfed for the first 3 months and they didn't feel any pressure to do it longer nor saw any problem in supplementing with formula when necessary.

        To give my Brazilian friend a correct answer based on facts and not only on my experience, I researched these topics and found this statistics:

        The Centers of Diseases Control and Prevention's 2011 breastfeeding report card (CDC), shows that in the U.S. National:
        • 74.6% were ever breastfed 
        • 44.3% were still breastfeeding at 6 months
        • 23.8% were still breastfeeding at 12 months
        • 35.0% were exclusive breastfeeding at 3 months
        • 14.8% were exclusive breastfeeding at 6 months

        They also show on their CDC National Immunization Survey (Breastfeeding Among U.S. Children Born 2000—2008), that:
          • approximately 25% of the breastfed children were supplemented with infant formula before they were 2 days old
          • approximately 38% of the breastfed children were supplemented with infant formula before they were 3 months old
          • approximately 45% of the breastfed children were supplemented with infant formula before they were 6 months old

          On the World Health Organization (WHO) Infant and Young Child Feeding Data by Country chart, you can see the difference between the breastfeeding statistics between Countries. For example, in Brazil (2006-07):
          • 96.4% were ever breastfed
          • 49.0% were exclusive breastfeeding at 4 months
          • 39.8% were exclusive breastfeeding at 6 months

            In Brazil they have a large breastfeeding campaign. They have prime time commercials showing famous actresses breastfeeding their babies and talking about the benefits of it. To help promote breastfeeding they have recently extended the maternity leave from 120 days to 180 days (On the United Nation Statistics Division website you can find a table with a list of all countries showing the length of the maternity leave and the percentage of wage paid in the covered period. The maternity leave varies from 7 weeks in Lebanon to 480 days in Sweden).

            There is no question that exclusive breastfeeding is the most complete and healthy form of nutrition a baby can have it, but it is CERTAINLY not easy to do it.



            Picture source: Daquella Maneira




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