Falls

 

My baby fell off the couch. What should I do?

Whenever your baby takes a serious tumble — from a couch, bed, highchair, crib, or countertop, for example — you'll need to do a thorough check for injuries, especially if he falls on his head or back.

You'll want to make sure that your baby doesn't have any serious wounds, that he hasn't broken any bones, and that he hasn't suffered a concussion or other internal damage. Falls can be serious, but because your baby's bones are soft, they don't fracture as easily as those of an older child.

If your baby looks okay to you and seems to be acting normally, chances are the fall didn't cause serious injury. Be thankful, but keep an eye on him. Continue to carefully observe your baby for the next 24 hours, especially if he bumped or fell on his head.

And err on the side of caution: If you're uncomfortable with the severity of your baby's fall — you think he had to have gotten hurt — or if your baby is acting irritable or confused, take him to the doctor to get checked out.

Call 911 if your baby experiences any of the following after a fall:

• A loss of consciousness. If your baby isn't breathing, have someone call 911 while you administer infant cardiopulmonary resuscitation (CPR) until help arrives. If you're alone, give your baby CPR for two minutes, then call 911 yourself.
• Bleeding that you're unable to stop with pressure.
• If your baby is breathing but not responsive — he's unconscious after the fall or you're unable to wake him up after he goes to sleep, for example.
• Take your baby to the emergency room or talk to his doctor immediately if you notice any of the following:
• Signs of a broken bone, including an obvious deformity, like a wrist that is bent awkwardly, or an arm or a leg that seems out of alignment.
• Signs of a possible skull fracture: A large, soft area on the scalp, especially on the side of the head (above or behind the ear); blood showing in the whites of his eyes; or pinkish fluid or blood draining from his nose or ears.
• Signs of a concussion, such as unusual eye movements or pupils that are unequal in size; persistent vomiting; or excessive sleepiness. Depending on your baby's age, look for a change in how he crawls or walks; weakness or confusion; or problems with speech, vision, or motor skills.
• Prolonged crying or screaming, which could indicate a possible internal injury.

What should I do if my baby develops a bump on his head?

"Goose eggs" on the head are common, especially in babies who are just learning to get around by themselves. Although a bump on the head can look scary, it doesn't necessarily mean that your baby is seriously hurt. When swelling occurs on the head, much of it protrudes outward because your baby's skull is just under the skin.

To help the bump go down, wrap an ice pack (or a bag of frozen peas, in a pinch) in a thin towel or diaper and hold it on the bump for 15 to 20 minutes. Nursing or feeding your baby during this time can help distract him from the chill and discomfort.

If you think that your baby is bothered by the bump, ask his doctor about giving him the appropriate dose of acetaminophen or ibuprofen. Never give your child aspirin, which can lead to a rare but serious condition called Reye's syndrome.

My baby has just started walking and falls a lot. How can I reduce his risk of serious injury?

When babies start to walk, they seem to take more stumbles than steps. Minor bumps and bruises are an unavoidable part of developing motor skills and independence. As long as your baby is under constant adult supervision and his play area is free of ungated stairs, sharp edges, and other hazards, most falls will not cause serious injury.

When your baby does take a tumble, try not to overreact. Rushing to your baby's side every time he stumbles will wear you out and make him overly cautious. If he's upset, calmly comfort him and encourage him to get back on his feet.

Still, falls are the number-one cause of accidental injury in children, and one in three of these accidents is preventable. So do what you can to keep your baby safe, including:

• Cushion sharp corners on furniture. Because they're low, coffee tables are common culprits in childhood bumps and bruises. You may want to pad the corners of your coffee table, or you may find it worthwhile to pack the table away until your child is a more confident walker.
• Put skidproof pads under all rugs. Or remove throw rugs until your baby is more sure-footed. And use a nonslip mat to keep your baby from sliding once you're bathing him in the big tub.
• Keep your baby away from elevated porches and decks, and place gates at the top and bottom of each staircase. (Choose a mesh gate rather than the accordion style, which can trap and pinch little fingers.)
• Be extra vigilant about holding your baby on the changing table. Some tables have straps that can help you keep your grip on a real wiggler, but they may not be enough to prevent a fall, so don't ever leave your baby on the table unattended.
• Keep the stairs in your home free of objects that you might trip over when you're carrying your baby.
• Lower your baby's mattress as soon as he starts standing up in his crib.
• When you're at the grocery store, buckle your baby into the shopping cart. And don't walk away from the cart, even for an instant. Also strap your baby into his stroller and his highchair.
• Keep a sharp eye on your baby at all times if he's started climbing on the furniture. You'll want to act quickly to keep him from falling.
• Use window guards on windows. Don't rely on screens, which aren't designed to keep a child from falling out.

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Caring For A Baby With Down Syndrome

Down Syndrome: Caring for a Baby Who Has Down Syndrome

What is Down syndrome?

Down syndrome is a genetic disorder that causes mental retardation and physical defects. It is caused by the presence of an extra copy of chromosome number 21. This condition is called trisomy 21.

How is Down syndrome diagnosed?

Before birth, tests (such as amniocentesis and chorionic villus sampling) can check the tissue and fluid in the womb for the extra chromosome. After birth, if the baby has any of the physical signs or birth defects of Down syndrome, your doctor can test the baby's blood for the extra chromosome.

What are the physical signs and birth defects of Down syndrome?

Some of the most common physical signs of Down syndrome are upward slanting eyes, flattened facial features, ears that are small or unusually shaped, broad hands with short fingers and curved "pinky" fingers and a small head. None of these physical differences cause health problems.

Some birth defects associated with Down syndrome cause more serious health problems. Babies who have Down syndrome often have poor muscle tone or problems with their heart, intestines or eyes. Intelligence ranges from low normal to very retarded (slow to learn), which can make learning and development more difficult.

How will I take care of my baby who has Down syndrome?

Just like any other newborn, you will need to feed, dress, diaper, cuddle, hold, talk to, play with and love your baby. Your baby also may have some health problems that require extra care.

What are the health problems that might affect my baby?

Some babies who have Down syndrome have poor muscle tone. This makes it harder for them to learn to roll over, sit up and walk. Physical therapy can help with these problems.

About half of babies who have Down syndrome also have a heart problem. An ultrasound exam of your baby's heart will show any defects. Surgery may be necessary to fix the heart problems associated with Down syndrome.

Some babies who have Down syndrome have problems swallowing, or they may have blockages in their intestines. Surgery may be necessary to fix these problems. Once they are fixed, they usually cause no further harm.

Some babies have eye problems, such as cataracts (cloudy lenses) or crossed eyes. Corrective lenses or surgery may be necessary to fix these problems.

Children who have Down syndrome may have colds, ear infections and sinus infections more often than other children. They are more likely to have thyroid problems, hearing loss, seizures and problems in their bones and joints. It's also common for these children to be late in teething.

Will my child be able to do the same things as other children?

In many important ways, children who have Down syndrome are very much the same as other children. They have the same moods and emotions, and they like to learn new things, play and enjoy life. You can help your child by providing as many chances as possible for him or her to do these things. Read to your child and play with him or her, just as you would any other child. Help your child to have positive experiences with new people and places.

Early intervention programs can help children who have Down syndrome develop motor, language and social skills that will give them the best chance of success.

Will my child have learning problems?

At birth, it isn't possible to tell how smart a baby who has Down syndrome will be. Intelligence ranges from low normal to very retarded (slow to learn) in people who have Down syndrome. If you keep your child physically healthy and provide therapy or treatment for his or her impairments, he or she will be better able to learn. With therapy, many children who have Down syndrome grow up to have jobs and live independently.

What other special care will my baby need?

You may need to give your baby medicine. Your doctor will probably want to check your baby often to be sure that he or she is growing well and isn't developing problems from birth defects.

Your baby may need to have physical therapy every week to help with building up muscle tone and coordination. Later on, speech therapy and occupational therapy (to help with issues such as language skills, hand-eye coordination and social skills) may be helpful for your child.

Can I breastfeed my baby?

Breastfeeding is good for all babies, including babies who have Down syndrome. Your baby may be a little slow in learning how to breastfeed, but it is possible.

When your baby is learning to breastfeed, you may find it helpful to talk with your doctor, a nurse or a therapist who has had special training. Other mothers who have breastfed babies who had Down syndrome can also give you helpful advice. Your doctor can help you find other mothers to talk to.

If I've had one baby with Down syndrome, am I at greater risk of having another?

In most cases, for every 100 couples who have another baby, 1 will have another baby with Down syndrome. If you're planning on having more children, talk with your doctor. He or she can help you decide whether to seek genetic counseling.

Since I learned my baby has Down syndrome, I've been confused and upset. What can I do?

You may feel disappointment, grief, anger, frustration, fear and anxiety about the future. These feelings are all normal. Talking to other parents of children who have Down syndrome can be helpful, because they know how you are feeling. You can also talk to your family doctor or visit a support group where you can share your feelings and get additional information. Several support groups, organizations and community resources exist to help children who have Down syndrome and their parents, siblings and other family members.

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