A:  After the first few days of life when your baby has meconium bowel movements that are very dark and sticky, it’s normal for your newborn’s poop to begin to be very watery and seem like diarrhea.  Breast fed infants, in particular, have BMs that are loose and seedy and range in color from brown to mustard yellow to green.  A typical newborn’s poop looks a lot like grainy mustard–think Grey Poupon country style!

Q:  My newborn must have a cold because he keeps sneezing.

A:  It’s very unlikely that your baby is sick.  Newborns often sneeze quite a bit and we think of it as nature’s way of allowing your baby to blow his nose.  New babies have very small nasal passages and usually make a little bit of mucus which can produce some degree of nasal congestion.  This usually isn’t a problem, but because newborns don’t know they can breathe through their mouths, you may hear your newborn’s breathing and think it means he is having difficulty.  As long as your baby is feeding well, is content, doesn’t seem to be struggling to breathe or crying a lot (which forces babies to mouth breathe) he is likely just fine.

Q: We want to take our baby girl to a party but she is only 2 weeks old.  Is this OK?

A:  The immune system of a newborn is immature and the more people she is exposed to the greater the likelihood she may catch something which could cause her to become quite sick.  We generally stress being very careful regarding hand hygiene and potential exposure to germs for the first 60-90 days of life, when pediatricians consider a fever a sign that an infection may be serious.  Hand washing is the best way to prevent introducing illness-causing germs to your newborn; proper cleaning of your hands involves rubbing them together for 15 seconds (or 3 rounds of “Row Row Row Your Boat”) with good old soap and warm water or the use of an alcohol based hand sanitizer.

Q:  Which hand sanitizers are best?

A:  Generally we recommend an alcohol based product which is rated 0-2 on the Environmental Working Group (EWG) cosmetics database toxicity scale (http://www.cosmeticsdatabase.com) so that you’re sure to purchase something effective while avoiding highly toxic ingredients.  This is an important factor when considering what to buy for you and your baby.  EWG is a tremendous resource available to guide purchasing decisions.  Babies and small children have very thin skin and immature detoxification systems, and thus are vulnerable not only to what we feed them but also to what we use on their skin, what we clothe them in, and what they breathe.

Q:   Do I need to give my 2 month old baby Vitamin D drops?  There is not much sun in our San Francisco neighborhood and we spend most of our time indoors.

A:  Vitamin D is important to our health and many of us have insufficient levels due to lack of adequate sunlight exposure or supplementation.  The American Academy of Pediatrics (AAP) recommends all children receive a vitamin D supplement starting in the first few days of life because evidence has shown this could have life-long benefits.  Furthermore, because of the growing body of evidence that a pregnant woman’s vitamin D status is important to her developing fetus, the AAP has recommended that physicians caring for pregnant women consider vitamin D testing during pregnancy.

At GetzWell we test all new mothers’ vitamin D levels and often find they are lacking.  This is critical both for mothers’ health and directly impacts the breast feeding baby.  Once we have these results, we can tailor our recommendations to each mother and baby as part of our effort to optimize the health of our patients and families.

Checking your vitamin D level is accomplished via a simple test your doctor can order.  Once you know your vitamin D level, your doctor can help you with a supplementation plan, if necessary, to ensure you and your baby are getting adequate amounts of this vitamin.

At GetzWell, we provide nutrition counseling for pregnant women in order to optimize nutritional status at this crucial time in your baby’s development.  We believe whole kid care starts before your baby is born and want to be involved as early as possible in your child’s health.

Here’s what the American Academy of Pediatrics is saying:

“Given the growing evidence that adequate maternal vitamin D status is essential during pregnancy, not only for maternal well-being but also for fetal development, health care professionals who provide obstetric care should consider assessing maternal vitamin D status by measuring the 25-OH-D concentrations of pregnant women. On an individual basis, a mother should be supplemented with adequate amounts of vitamin D3 to ensure that her 25-OH-D levels are in a sufficient range (>32 ng/ml). The knowledge that prenatal vitamins containing 400 IU of vitamin D3 have little effect on circulating maternal 25-OH-D concentrations, especially during the winter months, should be imparted to all health care professionals.” (Pediatrics. 2008 Nov;122(5):1142-52.)

Inadequate vitamin D has also been associated with rickets in children, osteoporosis, muscle weakness, fractures, common cancers, autoimmune diseases, cardiovascular diseases, and depression.  One recent study conducted by Harvard researchers showed that if mothers take vitamin D while they are pregnant, their children are less likely to have wheezing illnesses during the first 3 years of life.  Another study indicated that the median adult intake of vitamin D in the US is only 230 IU per day versus the 2000 IU daily dose which is recommended by the Mayo Clinic and the Vitamin D Council.

Vitamin D is not found in many foods, but we are able to make lots of vitamin D in our skin when we spend just 10-15 minutes in the sun (without sunscreen).  The lower back is an ideal part of the body to expose to the sun so that we make plenty of D vitamin but don’t need to worry about wrinkles!  Unfortunately, between October and March in San Francisco the sun is too far away to allow us to make vitamin D and much of the summer in SF is foggy, preventing the sun’s rays from reaching us.  So, for most of us a vitamin D3 supplement is necessary.

The Vitamin D Council contains a wealth of information: www.vitamindcouncil.org.