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Gastroesophageal Reflux and Infants

Posted by Alina on Sunday Oct 5, 2008 Under useful tips

Fifty to sixty five percent of otherwise normal two-month old infants regurgitate significant amounts three or more times a day.[1] When my son was 4 months old, he would eat both breast milk and formula. Often, after one-two hours after eating, he would spit up what seemed like a large amount of partially digested milk. When I asked his pediatrician about it, he thought that it was a bit of gastroesophageal reflux due to an immature sphincter (ring-shaped muscle that normally prevents the contents of the stomach from flowing back into the esophagus). He recommended we use the type of formula that has some rice cereal already mixed in, such as Enfamil AR. He said the condition should typically resolve by around 6 months of age. By six months of age, only 4 percent of infants are still regurgitating a significant amount three or more times per day.[2] At the time that I spoke to the pediatrician, my son was consuming 6 oz of formula three times a day in addition to breast milk. I tried Enfamil AR for a couple of days and it did not seem to make any difference in our case, so I went back to using Enfamil with Iron.

Now that my son is almost 6 months old, the spitting up has greatly lessened. He does spit up once in a while, but usually within minutes of eating, if he takes in too much. Sometimes he may spit up 30-40 minutes after eating, if he is in a seated position leaning forward (placing pressure on the contents of the stomach) or if he is playing on his tummy (probably also from the pressure). The amount, however, is much less than it was at four months. He currently takes only breast milk during the day and 3-6 oz of formula before bed time at night. We should be starting solids after his 6 month appointment, which should also help him to keep it all in.

1. Ramos AG, Tuchman DN. Persistent vomiting. Pediatr Rev 1994;15:24-31.

2. Jolley SG. Current surgical considerations in gastroesophageal reflux disease in infancy and childhood. Surg Clin North Am 1992;72:1365-91.

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Traveling with a baby

Posted by Alina on Wednesday Oct 1, 2008 Under baby safety, useful tips

By plane:
It is not necessary to buy a plane ticket for a child until they are two years old, however, the Federal Aviation Administration (FAA) recommends that parents of children younger than two years buy a ticket and use a car seat on the plane. Some airlines offer discounts for children younger than two, so make sure to notify them if you are buying such a ticket. If you don’t buy a ticket, you have to hold them on your lap or you may be able to get a bassinet, but you must ask for it well in advance. One piece of advice given to me was to purchase the aisle and window seats, because a single middle seat is the least attractive option for someone flying alone. Bring the baby in the car seat all the way to the gate, and when getting on the plane ask if there are any unfilled seats on the plane. If there is an empty seat, the flight attendant may be able to help you arrange to have a seat for your baby’s car seat. If all seats are filled, you can check your car seat at the gate.

By bus in NYC:
You must carry your baby and collapse the stroller while on the bus.
My personal experience with the bus was not extremely pleasant. It was heavy to have to drag the diaper bag, the stroller (in collapsed position) and my son in a carrier. Having to sit at the front of the bus with all the stuff, I felt like I was in the way of people getting on and off. Also, as the bus moved and swayed, I found it a bit difficult to hold on to the stroller while holding the baby and the bag so that nothing would fall. I think traveling without the stroller, with the baby in a carrier, would have made for a much better experience.

By car:
In NYC your baby must be in a rear facing car seat until 1 year of age and 20 lbs. After that he/she must still be in a car seat, but may face forward until he/ she is 40 lbs. Until the child is 65 lbs, he/ she must be in either an appropriate car seat or booster seat (facing forward).
**When traveling in a taxi in NYC, the car seat law does not apply, thus the baby does not have to be in one, although for his/her safety, it is wiser to use one.

By Subway:
In NYC, you can bring the stroller on the subway and do not have to collapse it. I would advise against traveling in rush hour with a stroller if possible, due to overcrowding. The greatest challenge is getting in and out of the subway, because many stations do not have elevators, and some that are marked on the subway map as “handicapped accessible” have elevators that will bring you to a platform of the train traveling in only one direction, not both. I have found  people on the subway to be very helpful with carrying a stroller for a mom who has a baby in her arms, you may just have to wait by the staircase for a few minutes.

By train (Amtrak/ LIRR):

Amtrak:

According to Amtrak.com; “Children under 2 years of age traveling free may occupy a vacant seat only if it is not yet needed for a paying passenger. If a child under 2 years of age does occupy a seat without paying a fare, the conductor has the right to request the child be removed for a fare- paying passenger, or the passenger has the option of purchasing a ticket to allow the child to continue to occupy the seat.”

A stroller may be checked in as a “special item” for a fee of $5.00.

My husband, 5 month old son and I recently traveled by Amtrak from NYC to Montreal, Canada. We brought the stroller onto the train with us both ways (did not check it) and occupied the handicapped area seats. These seats have extra space in front so the stroller can stand opened, directly in front of you and there will still be decent leg room. It was great to have the stroller with us during this ELEVEN HOUR TRIP, to be able to put our son down so he could play or nap. One thing to keep in mind is that there are “red caps” (guys wearing red caps), who work for Amtrak, and for a tip, can help you bring your stuff and escort you onto the train before everyone else, so that you can get those special seats. You should see the red caps if you look around where tickets are sold or near check in posts.

LIRR:

According to http://www.mta.info/lirr/pubs/TicketInfo.htm:
“Children under 5 years old ride free at all times. Children ages 5-11 travel at half the adult fares. These tickets are sold as an option under “One Way” or “Round Trip” ticket buttons on Ticket Machines.”

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