STORY BY

Melissa McDonald

Being a parent is just plain scary. There are more hurdles to childrearing than there are toy recalls from China. Even scarier: there is no perfect way to raise a child. Parenthood is a never-ending series of questions, often with conflicting answers.

Once again, we have collected your questions and queried our experts at The University of Texas Medical School at Houston.

Here are the next top seven questions parents ask and their answers.
(And, in case you missed them, here are the first seven questions and their answers.)

1. Is spitting up normal?
When should I worry?

Gastroesophageal reflux (GER or spit up) is common with babies. In fact, more than half of all babies experience reflux in the first three months of life, and most infants stop spitting up by 12 months, according to Dr. Lynnette Mazur, professor of pediatrics at the UT Medical School at Houston. “Only a small number of infants can have problems surface because of GER, such as refusing food and suffering weight loss. Pneumonia can develop if some of the spit-up fluid gets into the airway and lungs. Those are the extreme complications in which GER becomes GERD, gastroesophageal reflux disease,” says Mazur.

That’s why well baby check-ups are so important. Your pediatrician will use growth charts to determine whether your child is thriving. If your baby's growth is on course, just consider spit up a nuisance that he/she will likely outgrow.

“This is when breastfeeding can also be beneficial. Infants who are breastfed also tend to spit up less,” says Mazur.

2. My daughter is 5 months old, and I place her on her back to sleep to reduce the risk of SIDS (Sudden Infant Death Syndrome). She flips onto her stomach while she sleeps. What should I do?

Dr. Laura E. Ferguson, associate professor of pediatrics, says while the mother is correct in placing the baby on her back to sleep, babies who are developing normally may turn over onto their stomachs all by themselves after about 4 months old.

“The ability to turn over also implies that she has acquired the motor skills to return herself from her tummy to her back, and that she can lift her head and turn it to protect her own airway if she vomits or has a cold,” Ferguson says.

There is no way that parents can monitor their children through the night to see if they flip onto their stomachs, but there are guidelines you need to remember.

“In this age group, it is very important not to have bumper pads, pillows or too much soft bedding or toys. All those items are considered dangerous when it comes to SIDS,” Ferguson warns.

The peak age of SIDS is between 2 and 6 months. Once a baby begins to flip on his/her own, the risk of SIDS declines. Just remember to put infants on their backs to sleep and if they flip over, don’t panic.

3. I heard baby walkers are not safe, but stores still sell them.
Are they really dangerous?

Stairs are the number one reason why walkers are not considered safe. High incidences of babies falling down the stairs in their walkers have been reported. “The injuries are more severe than if the baby were crawling and fell down the steps. Even a few steps can cause significant head trauma,” says Dr. Lisa de Ybarrondo, assistant professor of pediatrics.

In the September 2001 issue of Pediatrics, there was a study from 1997 that found baby walkers sent more than 14,000 babies to the emergency room. Between 1973 and 1998, the walkers were involved in 34 infant deaths. The American Academy of Pediatrics recommended banning the production of baby walkers in 1997. Instead of banning them, manufacturers are now required to make the base wider so they can’t fit through standard doorways, and also are designed to stop at the edge of a step.

According to de Ybarrondo, stationary play stations are quite safe. They are a good option for parents looking for something that will allow their child to stand up.

4. With all of the toy recalls,
should I have my child checked for lead poisoning?

Let’s begin by saying that no amount of lead is considered safe for use in toys or paint. “If you believe your child may have put a toy identified as containing lead in his/her mouth, get your child checked out by the pediatrician,” says Robert “Safety Bob” Emery, DrPH, assistant vice president for Safety, Health, Environment and Risk Management at The UT Health Science Center at Houston.

The concern with lead poisoning is for children under 6 years old, because they are growing rapidly and they tend to put their hands—and anything they can put their hands on—in their mouths. Emery says it is unlikely that skin exposure—simply touching a recalled toy—would be dangerous.

“We are more concerned about children inhaling lead (which usually can happen only in a factory setting) or by ingesting lead,” Emery says.  “Your child can be tested for lead poisoning by having a blood test.”

5. Is there a proper time to introduce a sibling?

No matter when it happens, making room (physically and emotionally) for a younger sibling will profoundly change the life of your first child. In some ways it can feel like a loss and a challenge to the older child, says Cathy Guttentag, PhD, assistant professor of pediatrics.

“The older child will have to share mom and dad’s attention. They will have to compromise when it comes to their schedules and activities. They have to share possessions and generally give up the ‘throne' of being the center of their parents’ attention,” Guttentag says.

On the other hand, having a new baby in the house provides opportunities for helping and sharing, which can help your first child to feel special and important. You may be pleasantly surprised by the sense of maturity that becoming a big brother or sister brings out in your child. Parents need to have extra patience when it comes to their older child.  Extra cuddles and attention can go a long way in making the transition easier.

“There is no ‘magic number’ of years to aim for between children,” Guttentag says. Parents trade one set of challenges for another when it comes to spacing.

When siblings are two years apart or less, they will be closer developmentally: wearing diapers at the same time, playing together more, and being on fairly similar daily schedules. This can be very demanding for parents, however, with frequent sibling squabbles and both children wanting your attention at the same time, in similar ways.

Spacing children farther apart means your older child will be more verbal and may be more eager to be helpful and nurturing toward the baby rather than competitive. However, it can be daunting for parents to "start all over" with those early stages again with the next child: the naptime schedule, the diaper bag, toilet-training, etc.  Juggling the schedules and activities of children at different developmental levels may be more challenging than double strollers.

"My recommendation is to go with your personal/family preference and recognize that Mother Nature may or may not cooperate!” says Guttentag. Remember that there will be both joys and frustrations, no matter how carefully you try to plan the timing.

6. Are tanning salons safe for teenagers?

Mazur says if you think tanning beds are safe because they’re legal, think again. “A tan is not a healthy glow. It is the body’s response to your skin being injured by the sun. Skin damage happens whether a tan comes from the sun itself, or from the artificial light that is produced in a tanning salon. In fact, the longer wavelength UVA used in tanning beds penetrates more deeply into the skin,” Mazur cautions.

A study in the British Journal of Cancer shows that the risk of melanoma is 8.1 times greater in persons who used tanning salons when compared to non-users.

California already prohibits anyone younger than 18 years of age from using tanning salons.  Currently, there is no similar law in Texas.

7. When should I talk to my child about sex?

Start early—that’s Dr. Michelle Barratt’s advice. The first rule is: Be honest. “You can start when your child is just a baby.  You can do that by teaching them all of the proper names for their body parts. When they move into toilet training, that is the perfect time to teach them about their bodies,” says Barratt, professor of pediatrics.

As the child encounters areas of life that reflect on aspects of sexuality, the parent needs to answer truthfully and within the family values. The 4-year-old discovering a box of tampons has the perfect chance to hear from her mother about the female organs and where they are located.

Barratt says as the child matures, build on that foundation. When they begin to start asking about dating, that would be a good time to talk about sex and your family’s values. “Don’t plan on having ‘the talk.’ Children’s curiosity comes in small and large doses depending on what they are experiencing. We as parents need to meet them in the moment,” Barratt advises.

UPDATED: 9-26-2007

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