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July, 1991
GROWTH CHARTSDid you ever wonder why we don't comment on your child's percentile of height and weight during your well-baby visits? We feel that growth charts and their accompanying percentile figures overemphasize factors which are not within a parent's control. If you breast-feed your baby for six months and then introduce healthy natural solid foods, your baby will grow and gain the appropriate amount of weight which he has been genetically programmed to gain. All too often we have seen parents who force feed their children high caloric food in order to get them into the 90th percentile of weight in an attempt to "keep up with the Jones" or to satisfy an anxious grandparent. In de-emphasizing growth charts we hope to lessen anxiety regarding infant feedings. We take a similar attitude during pregnancy regarding a woman's weight gain. As long as the quality of the prenatal diet is excellent the number of pounds gained will be correct. This is why we examine your menu logs during pregnancy--it gives us much more information than merely calculating your weight gain. On a similar subject, parents ask when their baby will be ready for solid foods. They become concerned at 3 or 4 months when the child's oral activity increases and everything is placed into the mouth. Many parents interpret this as a sign that the child is hungry and is no longer satisfied with only breast-feeding. Reassurance is indicated here that mouthing objects is a normal stage of development and does not suggest the need for solid foods. The baby will give you a clear signal when he is ready for solids. This will usually occur at 6 months of age or later. The baby will probably have several teeth by then and will be able to sit in a high chair. When the baby watches you eat he will demand that you feed him! These are very clear signals that the baby gives. Don't worry--you will not miss the proper time! Remember, breast milk is still the perfect food for babies through one year of age so your child's nutritional needs are being met even if he is late to start solids, or if he eats very small amounts. It is important for lactating mothers to keep up their healthy nutrition, vitamin supplementation, and high liquid intake during this period. Early introduction of solid foods is not a solution for infant sleeping problems--this has been confirmed by a recent scientific study. If your baby seems to be having sleeping problems, please discuss this with Dr. Elvove.
HPH BIRTHING CENTER OPENThe brand new building housing the birthing center of Highland Park Hospital opened on June 1. The Center features 16 new "LDRP" rooms in which families can remain throughout Labor, Delivery, Recovery, and Postpartum and until discharge without having to shuttle back and forth to the delivery room during the intense pre-delivery contractions. The rooms are large and all have a picture window, telephone, and private bathroom and shower. 24 hour rooming-in is offered for the newborn and the staff includes lactation consultant and neonatology services. Congratulations to Highland Park Hospital for making a valiant effort to compete with the comfort aspect of home birth!
HIB VACCINE APPROVED FOR INFANT USEThe U.S. Food and Drug Administration has approved the HIB conjugate vaccine for use during infancy. The vaccine which protects against meningitis caused by the Hemophilus Influenzae group B bacteria, was previously approved for use between 18 months and 5 years of age. After our initial 6 month observation period to determine that there were no harmful effects from the vaccine in the general public, we have started making this vaccine available to infants over 2 months of age. Please call the office for further information.
LOW CESAREAN RATE FOR HOME BIRTHSEveryone can understand that giving birth at home is more comfortable for the mother, and a family-centered experience which draws the family close together. Grandparents who have witnessed the miracle of their grandchild's home birth later express a special closeness to that child. We also know that the threat of infection has always been less at home. The bacteria and viruses present there are strains which the pregnant woman has already been exposed to and therefore the antibody protection is passed along to the baby across the placenta even before birth. What is not so obvious is the extremely low rate of Cesarean Section among those women who received final clearance from Dr. Elvove to deliver at home. This number is 6% compared to the local hospitals who are running Cesarean rates of 18-35%. This difference is extremely significant when you consider that damage to the mother occurs 5-10 times more often following a Cesarean section which is a major surgery than after a normal delivery. The rising rates of Cesarean section have become the focus of several national investigations studying the issues of rising health care costs and unnecessary surgeries. Perhaps the answers to these inquiries lie no further away than the front door of our own homes. Here are some of the reasons for our success in keeping down the C-section rates: (1). Couples who have chosen home birth have developed a high level of confidence and faith that they can deliver at home without the aid of common interventions such as IV's, monitors, narcotics, epidurals, Pitocin stimulation, etc. (2). Laboring women are more comfortable in their own home. They can walk around, eat if hungry, use their own bathroom and shower, invite whomever they wish to attend, all without requesting anyone's permission. There is no ride to the hospital to interrupt progress in labor. There are no external interferences or tensions to be overcome, so all energies can be focused upon the task at hand. (3). The needs of the laboring woman are catered to by her devoted relatives and friends, and by the nurse and doctor in attendance. She is their only patient and the center of their constant attention. Birth is not treated merely as a procedure with which to terminate pregnancy, but rather as a joyous, miraculous event for all to cherish fondly forever. (4). The medical screening is very thorough before permission is granted to deliver at home. Mothers with high blood pressure, diabetes, twins, smoking, breech presentation, prematurity, and other risk factors are scheduled for hospital birth before delivery. We spend time reviewing diets, discussing exercise, reviewing postpartum care arrangements, and encouraging breast-feeding both during the office prenatal visits and in our own special evening prenatal education series. By spending more time we can establish a trusting relationship where there are no surprises when labor comes, unlike in other medical groups where a doctor you may have never met before shows up for the delivery. These are some of the reasons for the lower Cesarean rate and certainly those of you who have delivered at home can think of many others.
NO MESS BIRTHINGWe have often heard the question, "Isn't having a baby at home terribly messy?" The answer is, "Not at all!" with a few simple supplies available either in the Home Birth Supplies Kit from our office, or at the drug store. Underpads and waterproof sheets for the mattress can be disposed of immediately after use and the bed can be prepared for sleep shortly after the baby is born.
NEWBORN CIRCUMCISION RATE DECLINESTen years ago the American Academy of Pediatrics issued their recommendation against routine newborn circumcision. Their recommendation is finally having some effect by lowering the circumcision rate among male newborns. The lower rate is a combination of pediatricians recommending against the routine performance of the procedure and the insurance companies refusing to pay, since newborn circumcision is now deemed medically unnecessary. Circumcision of the newborn is the most common surgical procedure performed in the United States. It used to be thought that circumcision would lower the rate of infection and cancer, both in the man and in his sexual partner. However, well-controlled studies have shown that there is no increased risk for these problems in uncircumcised men. North America is the only continent where circumcision was practiced as a medically recommended procedure. Men in Europe or Asia are not routinely circumcised, and don't seem to have more problems with infections or cancer than their American counterparts. Furthermore, since circumcision is a surgical procedure, it carries the risks of bleeding, infection, or improper healing just as any surgical procedure can cause. Care of the uncircumcised penis is simple. The foreskin, the organ which is removed during a circumcision, protects the head of the penis from diaper rash, and therefore should not be retracted until after the child is out of diapers. Then the child can be instructed to gently retract the foreskin at the end of the bath or shower and clean underneath with plain water, just as you would teach him to clean behinds his ears. (Incidentally, no one suggests removing the ears to make cleaning easier!) Whenever a medical or surgical procedure is deemed routine, it arouses suspicion of a conflict of interest. Do those who perform the procedure or recommend the drug in question stand to profit financially from the procedure? If so, they are not a reliable source of unbiased information regarding the benefits and risks of the procedure. Routine circumcision of infants bears a resemblance to routine episiotomy in laboring women. Both are surgical procedures performed upon the genitalia in order to ostensibly correct some "deficiency of Nature". How could it be possible that Nature has developed a perfect system of conception, fetal development and labor, but made a mistake by inventing a birth canal which had to be cut upon (episiotomy) each time a baby passes through? Routine episiotomy makes no sense at all from this perspective, and neither does routine circumcision. If you have any further questions about circumcision or care of the uncircumcised penis, we have reference materials that we hand out in our office.
INFANT WALKERSBabies love to be placed in a walker, but unfortunately this device is potentially dangerous and can interfere with their motor development. Serious head and spinal injuries can occur if babies tumble down stairs in a walker. Accidents like this can occur very suddenly, because the baby is very mobile in his walker. The other problem with walkers is less obvious. Infants who spend much time in walkers prefer not to crawl because they find being upright much more interesting. Developing the skill of walking begins with rolling over, creeping, then crawling, and standing, in that order. The physical ability to stand and the mental desire to stand should develop simultaneously. Putting a child in a walker interrupts this orderly process and places a child upright before the joints, muscles and brain have reached this point of development. If a parent is busy and must briefly leave a baby unattended, a playpen is much safer than a walker and doesn't disrupt the child's motor development. We don't recommend jumping toys for similar reasons. We admit that the babies do enjoy them, but this is not our point. Children need to pass through each stage of rolling, creeping, crawling and standing at their own pace before beginning to walk.
SUMMER HAZARDSummer is a time for outdoor adventure and fun for the family, but the season presents certain hazards for young children that parents should avoid. Solar UV (ultra-violet) radiation has come under the scrutiny of dermatologists recently because of its association with skin damage. With the depletion of the ozone layer the amount of UV radiation we are receiving is increased. Bad sunburns received during childhood have been implicated with the development of the deadly malignant melanoma skin cancer later in life. Use of a sunblock with a SPF (sun protection factor) of 15 will block out the harmful rays and prevent sunburn. Sunblocks should be reapplied after swimming even if labeled as "waterproof". Infants who have never experienced sun exposure before are especially vulnerable and should be kept in the shade with their heads covered with a broad-brimmed hat. Staff | Newsletters | Vitamins & Stuff | Recommended Reading | Links | Downloads George B. Elvove, M.D., P.C. © 2009, George B. Elvove, M.D., P.C. |