The first days and weeks at home

SIDS is the name for the sudden death of a baby younger than 1 year old and for which there is no cause found, even after extensive testing. In Flanders, this occurs in approximately 2 out of every 10,000 babies.

Given that we do know what the cause is exactly, we do not yet have a definitive way of preventing SIDS. Research and past experience show that there are measures we can take to lessen the frequency of occurrences of SIDS. Some important points of attention:

• Do not smoke during your pregnancy. Do not allow others to smoke around your or around your baby.
• Lay your baby on the back when you lay him or her down to sleep. This position does not increase the risk of choking or suffocation, even in the case of gastrointestinal reflux). As soon as your child can roll from his or her back onto the stomach, the sleeping position no longer matters.
• Swaddling does not increase the risk so long as your baby is laid down on his or her back. When your baby starts to try to roll over, you do not have to swaddle him or her anymore.
• Use a firm mattress and a well-fitting sheet. Do not use any other bedsheets, blankets, dust ruffles or soft objects that could lead to strangulation or suffocation.
• Keep the sleeping environment cool. A temperature of 20 °C is sufficient up until eight weeks old, after which 18 °C is recommended. Keeping the head (and especially the face) free plays an important role in maintaining a normal body temperature.
• Breastfeeding protects against SIDS, as does the use of a pacifier.
• It is recommended that you have your baby sleep in your bedroom, but not in the same bed with you. This should be done until at least 6 months of age.
• When your baby is awake and under supervision, place the child on his or her tummy often to limit any deformation of the back of the head and to stimulate psychomotor skills.
• A home monitor is not a useful way to lower the risk of SIDS.

Source: SIDS and Other Sleep-Related Infant Deaths: Evidence Base for 2016 Updated Recommendations for a Safe Infant Sleeping Environment. Moon R, TASK FORCE ON SUDDEN INFANT DEATH SYNDROME. Paediatrics 2016:138(5): e20162938

All babies cry, and almost every baby becomes more calm when he or she is touched or held on someone's lap, with rocking or singing... Try not to limit this kind of contact to times when your baby is crying. Otherwise, he or she learns that crying is the only way to get attention.

When your baby cries:

• Try to figure out what your baby needs: to be fed, to be cuddled, to be quieted...
• Do not react immediately to the first cry. Do keep an eye on your baby.
• Avoid over-stimulation.
• Children who cry a lot often need regularity, such as a predictable daily routine. It makes life predictable for a baby, and your baby will be calmer.

Some babies really scream, which can be really challenging for you. This can lead to a situation where parents becomes desperate, exhausted and angry.

If this happens, try:

• talking or singing softly to your baby
• checking whether your baby is too warm
• taking a walk with your baby
• ruling out hunger, and if your baby has already been fed, give him or her a pacifier

If you have tried all of the above suggestions, but without success, place your baby in his or her bed, turn the lights off and give yourself the chance to calm down.

No matter how upset you may get, do not shake your baby. This can cause severe damage, including blindness or permanent brain damage, with handicaps or death as the result.

Do not hesitate to ask for help from family or friends if you really need help or a quiet moment.

You cannot spoil a young baby. Do not feel guilty about consoling and cuddling your baby when you feel the need to.

After two or three months, babies cry less and there are many benign reasons that your baby might become upset. If you do have the feeling that the crying is caused by something serious, trust your intuition and seek help.

Contact with outside air is not a problem at all for a healthy full-term baby.

• Do not expose your baby's skin directly to the sunlight. Delicate baby skin burns quickly and skin damage at a young age increases the risk of skin cancer over the course of one's lifetime.
• Do not over or underdress your baby: dress your baby in as many layers as you are wearing and use an extra coverlet.

For premature babies or babies who were born with a low birth weight, the risk of being too cold is higher. For this reason, follow these guidelines:

• Only go for a walk with your baby if you have absolutely no difficulties inside with maintaining his or her body temperature.
• Keep the first outings short and check the baby's temperature afterwards.
• Go out when the weather is nice and not raining, windy or foggy.
• During the springtime, autumn and winter, it is best to go out for a walk in the afternoon (the warmest time). During the summer, it is best to go in the morning or the evening (to avoid the sun at its hottest). 


It is better to avoid taking your baby to crowded places.

Source:

Having visitors is tiring for you and for your baby. Keep things relaxed. Organising a large get-together can be quite stressful, for yourself, and certainly for your baby - the pressure can be too much. Keep the following rules in mind:

• Let your baby rest as much as possible during the visit and do not bother him or her.
• No one may smoke in the room where your baby sleeps or is lying down.
• Your baby sleeps best at home in its own, familiar environment.
• Politely decline visits from people who have an infectious disease.

Flying presents no additional health risk for a healthy newborn, even though there are certain considerations:

• Children with chronic heart or lung conditions (e.g. premature babies) run a higher risk of low oxygen during the flight. For these children, the best advice is to ask the attending physician whether any additional tests are recommended.
• Ear pain at the time of taking off and/or landing can be truly awful for your child or baby. The pressure on the middle ear can be adjusted to the environment pressure by swallowing or chewing. You can help your baby by feeding him or her.
• There is no scientific proof that there are more symptoms or complications of ear infections associated with flying.
• Travelling over different time zones, jetlag, and a different daily routine can disturb your baby's sleep pattern as much as it disturbs an adult's sleep pattern.

Source 1: The effects of flight and altitude. Samuels MP, Arch Dis Child 2004; 89:448-455
Source 2: Taking young children on aeroplanes: what are the risks? Bossley C, Balfour-Lynn IM, Arch Dis Child 2008; 93:528-533

High altitudes expose us to cold, lower air humidity, increased UV rays and lowered air pressure. The biggest danger to health is the lower oxygen tension. The risk of oxygen deprivation depends on the altitude, how fast one climbs altitude and the duration of remaining at high altitude. People (including children) with insufficiently treated severe lung disease (e.g. premature babies), sickle cell anaemia, certain heart conditions, infections, muscle diseases or certain nervous system conditions run a higher risk of oxygen deprivation.

Climbing altitude slowly, acclimating (resting upon arrival), taking care to drink enough fluids and watching for symptoms of altitude sickness can be important. For children who cannot yet express whether they feel sick, certain signs can be very non-specific: irritability, inconsolable crying, being extremely clingy, poor appetite, sleepiness and vomiting.

Every child who becomes sick at an altitude greater than 2,500 metres should be immediately brought to a lower altitude. It is recommended that a child younger than the age of 2 should not spend the night at an altitude above 2,000 metres, and that between 2 and 10 years of age, to not spend the night at an altitude above 3,000 metres.

Source:

Vaccinations are meant to build up immunity. That is one of the mechanisms by which our body protects itself against the harmful effects of microbes. You can build your body's defences by exposing yourself to the microbes. However, with serious infectious diseases, we do not let nature just take its course. That is why we use vaccines to build immunity before diseases can be spread.

Immunisations are recommended for the following reasons:

• They can save your child's life. The most effective measures in medicine are preventative. And so, the most important reason to vaccinate your child is to keep your child from contracting a serious illness and to keep your child from dying from a complication from this illness. If your child were to become sick, medicine still does not have the means to ensure that the patient survives.
• Vaccines are safe and effective. The risk of serious side effects from vaccinations is extremely small and, at any rate, much smaller than the chance of developing serious complications from the diseases that they protect against.
• Vaccinations also protect others, for generations.

Some children who have experienced a serious reaction to a previous vaccine or children with certain immune disorders may not be vaccinated.

Different countries have different vaccination schedules available. These schedules are drawn up with the prevalence of infection and with the existing health care system in mind. In Belgium, the Belgian Health Council recommends a schedule that is also followed by the organisation Child and Family.

Cost effectiveness or population level, as well as available budget, also play a role, which allows for the availability and effectiveness of vaccines. They are not reimbursed, however. You cannot receive these vaccines from the ‘Child and Family’ organisation. You must buy the vaccines yourself and then have your GP or paediatrician administer them. Examples include vaccines for a certain form of mengicoccal infection and chickenpox. The health insurance does sometimes reimburse part of the cost.

Source: