Infant constipation.

Bowel habit varies between individual infants and frequency is affected by diet, fluid intake, age and behaviour. Less than 3 complete stools per week is considered a potential indicator of constipation in children under one year of age (excluding those exclusively breast fed after 6 weeks of age,)
An exclusively breast fed infant can pass up to 6 stools per day in the first 28 days of life.

The average "normal "stool frequency of formula fed babies is;-
at 1 week old         up to 4 dirty nappies per day.
At 3 months           2-4 dirty nappies per day.
At 6 months           1-2 dirty nappies per day
At 12 months         one dirty nappy every 2-3 days.

Constipation can occur for a variety of reasons.

• Change of formula milk, including change of brand or stage.
• Change to more semi solid diet
• Inadequate fluid intake.
• Illness with a raise in body temperature
• Side effect of some medications (e.g. baby Gaviscon)
• Medical conditions such as Diabetes, Cystic Fibrosis and low thyroid function.
• About 2 percent of children may experience constipation as a result of a congenital abnormality. 

The symptoms of constipation include;-

•  Distress and difficulty in passing stool.
• Reduction in feeding and becoming more "fussy".
• Overflow diarrhoea accompanied by offensive wind being passed.

How can this be resolved?

Circular massaging of the infant's abdomen, or gently stretching and cycling the child's legs when the child is warm and relaxed, can reduce the abdominal tension and allow stool to be passed.

If the infant is straining, put them on their back in a warm room with the nappy off and gently position the baby's knees against their chest will help them pass the stool.

A warm bath may help comfort baby by easing abdominal pain.

In small babies a 30 ml top up with plain boiled water, or boiled cooled water to which a level teaspoon of brown sugar has been added, should be enough to get things moving. This can be repeated. Baby should not be allowed to go longer than three days without a dirty nappy, unless this is normal for that child.

If baby has a swollen abdomen, temperature, blood or mucus in or around the stool, vomits or shows signs of reduced feeding, medical attention should be sought.

If symptoms persist, and baby is older than one month a small dose of oral lactulose may be prescribed to relieve the symptoms and allow stool to be passed. 

Five points to avoiding overheating baby.

Overheating can increase the risk of cot death. Babies overheat when there is too much bedding or clothing, or the room is too warm. Remember that a folded blanket is as warm as two blankets.
Lightweight blankets make it easier to control the temperature.
When you check on your baby, if he or she is perspiring, or their tummy feels hot to the touch, remove a blanket. It is absolutely normal that an infant's hands and feet are cool.
Room temperature of 16 to 18degrees C (63-65 degrees F) is a comfortable temperature,
The easy way to get it right is;-

• In summer baby may only need a sheet if it is very warm. (19-22 degrees C)
• Even in winter, most babies who are unwell or feverish need fewer clothes.
• Excess heat is lost through babies head, which is why it should never be covered at bed time, unless the room is very cold.
• Always remove hats and extra clothing as soon as you come indoors, enter a warm car,bus or train, even if it means waking your baby.
• Babies should never sleep with a hot water bottle, electric blanket, next to a radiator or in direct sunshine.

During the day baby should have one more layer of clothing than you have on. 

Children's growth and development.

From birth children are weighed and a note made of their OFC (head circumference) and length. Health professionals chart these measurements on a chart known as a "centiles chart". This allows an accurate following of the child's growth. Some weight loss is expected immediately after delivery but babies generally regain their birth weight by about 2 weeks.

If you look at a centiles chart, there is usually one in your child's personal health record, you will see that the graph has nine curves. Starting at -04th and rising to the 99.6th.
If you lined up 100 children of the same age, in height/length order you would find that, if your child is following the 25th percentile, your child would be number 25 in the row with 75 children taller.

Until a child is 2 years old the weight and length of the child are noted. From the child's second birthday the measurements change to a standing height measurement.

There is no exact measurement at which a child's measurement is abnormal, but, only one child in one thousand will follow the curve at 0.4th.

Weight gain is not the only important measurement, children can gain weight but not be thriving. When a child's weight crosses two percentile lines, for example a child who at birth and the first few months measured along the 50th percentile and then this falls to the 9th percentile, a referral should be made to a Consultant Paediatrician. Further investigation will determine if there is any underlying health problem which requires treatment.

Children do not always follow a centile line exactly an it is not unusual for a child to lose a little weight due to illness but will usually return to the initial centile after two or three weeks. If the charted measurements fall between one percentile curve and another, (e.g.between the 75th and 50th, or, 50th and 25th) that is not a cause for concern.

Children aged 2 weeks to 6 months should be measured and weighed once a month.
Once every two months at age 6-12 months.
Over age 12 months one measurement every three months is enough unless there are concerns about the child's eating or other health issue.

Children born before their due date should be charted on a "preterm" percentile chart, or, if they were born with a particularly low birth weight then the appropriate chart should be used.

When a child is a fussy eater these measurements can be an important indicator of whether this behaviour is affecting their growth and development. Some children have a limited diet but continue to grow and to follow the centile as they always have. Others may have a falling growth pattern. Where growth is failing and weight is rising but not to meet the anticipated pattern, further investigations are necessary.

Simple things like frequent coughs and colds, enlarged tonsils and adenoids, and gastric reflux can have a negative effect on children's growth. It is always important to recognise these and where necessary to treat them.

If you would like a UK percentile chart to plot your child's growth;-
 Contact Dream-Angus at info@dreamangus.com

Learning, genetics, habits and sleep.

Sleep is a complex thing. The sleep patterns we have as adults are composed in part of the sleep patterns of our parents, the sleep patterns we learned and the habits we have adopted.

Children are capable of learning sleep habits from as young as 60 days of life. We encourage them to sleep at regular intervals in infancy and we expect them to extend night sleep and reduce daytime sleep as they grow. Teaching a desirable sleep pattern is fairly easy, however children often pick up sleep associated habits which may be less desirable along the way.

Some professionals talk about "inappropriate sleep associations". What this really means, is that the child has learned that certain things are required to happen before they are comfortable and confident in being able to get themselves to sleep. Sometimes these are things that the child will grow out of. Sometimes one inappropriate association or habit is not eliminated but replaced with another just as inappropriate.

There are "recommended" lengths of sleep for different age groups but, these are not set in tablets of stone, they are guidelines only. Every one of us has a general sleep requirement, but how we have learned to sleep and the effects of previous generations on our genetic make up can, and does have some effect on our sleep pattern and on the sleep patterns of our children.

If your child has shorter sleep than the recommendation for his/her age and stage, look at the amount of sleep the parents need. Does your child generally wake in a positive happy cheerful mood? If so, the chances are that the sleep that they have had has been restful and restorative. A child who sleeps well in generally a child who is happy and copes well with the rest of the day.

Children need routines. These are there to act as touchstones. They help children understand the world and what is expected of them. As they grow these routines change slightly.
Every adult has at least three things which they do every night, regardless of holidays, before they are ready to go to sleep. The last routine of a child's day should consist of three things always completed in the same order, started at the same time of day and finishing in lying down to sleep.

Teaching good sleep habits is every bit as important as teaching good habits in other areas of life.

If you would like some help to teach your child good sleep habits, Contact us at;- info@Dream-Angus.com and we will help you.

Growing independence.

As children grow and learn to be comfortable in their environment they start to explore more. Although to begin with they will check back to see where mum or dad or their trusted adult is, they gradually extend their range. About this time there is a more defined character forming and they start to express their desires and emotions. Unfortunately some of these emotions are overwhelming and difficult for the child to understand. Lacking a vocabulary they resort to screaming, crying or simply having a full blown tantrum.

You can avoid a great deal of frustration for yourself and your child, if you accept and work with this growing independence. How many choices do you make in a day? How many does your child make?

Children understand "fairness" as a concept, even before they can walk. It must seem terribly unfair that they have so little say in their own lives. Offer your child a choice of things. Only offer two simple things to choose between, things which you can live with no matter what decision your child makes.

It doesn't have to be about big things, it can simply be which shirt or skirt to wear today, whether to brush your teeth or wash your hands first. Offering a choice of two things is less confusing. As your child learns to make these small decisions he/she is learning to take a small level of responsibility for their life. If the child has made several decisions then when you decide something for the child, it seems altogether fairer from the child's perspective.

Practising making small decisions makes taking the bigger step when the time comes, much easier. Your child believes he/she has some control and at the same time learns to live with the consequences of that decision. For example, offered the choice of shoes or boots in the morning, a child that chooses inappropriately learns that in some situations shoes/boots are a better idea. The parents are less likely to be seen as the "bad" guys because the decision was made by the child.

Obviously when using the "choices" approach you need to be ready to follow through. Accept the decision, which is why both choices should be ones you will be happy with. Praise a good decision and don't criticise a poorer one. Your child will quickly learn what works and what doesn't.

Ten things you can do to help your child to play.

Without play children have difficulties forming healthy relationships, they won't learn to develop and function in the world without positive play experiences. Active children are happy children, they are better adjusted, more co-operative with their peers and more popular because of it.

Parents who actively encourage play and communicate with their children provide excellent opportunities for speech and language development, information sharing and use of imagination. Here are ten ways you can help your child to develop through play. This is not an exhaustive list, merely a starter for parents who are uncertain how to encourage their child to become involved in their environment.

1) Allow yourself time to play with your child. We all lead busy lives, so we need to recognise the importance of playing with our children.

2) Have a couple of "treasure boxes" for children to explore. Natural materials, pine cones, leaves,shells,a short chain, a wooden spoon, keys, simple household objects can allow exploration of colour and texture and the developing of hand eye co-ordination. A dressing up box for toddlers, with a variety of old clothes of different materials are good starting boxes.

3) Communicate effectively by using facial expressions, eye contact and a positive tone of voice.

4) Use music to encourage your child to dance and to move more in their play.

5) Encourage messy play using jelly, spaghetti, Playdoh and sand.

6) Provide opportunity for water play with different containers, hose pipes and moulds.

7) Even when the weather is inclement, pull on warm waterproof clothing and get out to the park or beach. 

8) Read or look through books with your child and encourage them to tell a story or extend the story that they are familiar with.

9) Observe your child playing and  comment appropriately, this will help them develop vocabulary.

10) Allow your inner child to have some fun too!

Monsters in the bedroom?

It can be difficult for young children to differentiate between real life and imagination. Characters like Kermit and Big Bird are very real to pre school children. As a child's imagination develops, more imaginary characters can become real. When these characters are more threatening it can be worrying, and some children develop a real fear of being alone in their room. Parents need to recognise that although they know the environment is completely safe, in the mind of a child, monsters are very real indeed.

When young children "create" these characters they don't always understand how to banish them. Sometimes, they can become a little like imaginary friends and a relationship can develop which adults may find perplexing. If the child can talk about the character they "see" , and if the parent accepts this as the child's reality then a variety of techniques can be offered to calm, banish or kill the "monster".

Telling a child that there is nothing there and nothing to be afraid of, is logical to adults, but not always acceptable to the child. Some parents use "monster spray" a simple spray of water sprayed in the corners of the room, under the bed or wherever the child thinks the "monster" is lurking, can be effective. Sometimes it is better to create something the child can use by themselves. Praising their bravery in facing the scary helps the child to manage their own fear. There is usually something that your child can tell you that the monster will not like, it may be a torch, monster spray, a dream catcher, a ray gun or a simple "incantation" some noise or rhythm which "monster" doesn't like.

What scares you and how do you manage that fear?
If your child starts to talk about scary things and is reluctant to go to bed because of this it is time to review the media the child is exposed to and to ask more. Treating your child's fears as reasonable, will help your child to have more faith in you as being someone to confide in.  Together you can find a way to conquer these simple fears and help your child to become more confident in his/her abilities as well as your own as a parent