Pediatric Care

It is often hard for new parents to know how long and how often an infant should sleep. Generally, newborns sleep about 8 to 9 hours in the daytime and about 8 hours at night with interruptions for feeding. Most babies do not begin sleeping through the night (6 to 8 hours) without waking until at least three months of age, or until they weigh 12 to 13 pounds. However, this is very variable and some babies do not sleep through the night until closer to one year.

Green bowel movements are not uncommon in infants and are not of concern. However, your child should be assessed if they have bloody or chalky, white stools.

Maintaining good hydration is important for a child with diarrhea and/or vomiting. Breastfed babies should continue to drink milk and other children should be offered liquids often. If your child appears slightly dehydrated, you can offer small, frequent sips of an oral rehydration solution, which can be purchased at your local pharmacy.

Your child may continue to eat with diarrhea and/or vomiting. If they are vomiting, they may tolerate bland foods better, such as crackers, toast, rice, applesauce and bananas.

A fever is a body temperature of ≥38°C or ≥100.4°F. The most important thing to do for a baby or child with a fever is to keep them well-hydrated and comfortable. Fever can cause the child to temporarily lose extra body fluid, so offer breast milk or liquids often. Medicine, such as acetaminophen or ibuprofen, can help to reduce the fever. Follow the package directions for dosing. Dressing your child in light clothing can also help to keep him/her cooler.

Infants with a fever, who are less than 3 months old, should be assessed immediately. A child should be assessed urgently if he/she is urinating less, lethargic, having difficulty breathing and/or is not responding to fever medicine.

If your child’s fever is not improving after 48-72hrs or if you have other concerns, please contact your primary care provider’s office.

Your child can start solids between 4-6 months of age when they start to show signs of readiness. Signs of readiness include, but are not limited to:

• Sitting up with little support
• Holding their head up
• Showing interest in the foods that you are eating
• Opening their mouth wide when food is offered on a spoon
• Using lips to remove food from the spoon
• Signaling refusal (turn their face away to show that they are not hungry)
• Keeping food in their mouth and swallowing

Start with pureed or well-mashed foods, either store-bought baby food or homemade. Begin to offer the food after breastfeeding/bottle feeding. Ensure your child is sitting upright, then offer a small amount of solids from a spoon. Your child will determine his/her portion, there is no set amount. Expect and prepare for a mess!

It is recommended that you start with iron-rich and protein-rich foods, which will help your child grow. Cow’s milk should not be introduced until at least 9 months of age and honey should be avoided until 1 year of age. Foods that are more commonly allergenic (e.g. nuts) may be introduced at any time (just be sure they are not a choking risk), however you may wish to introduce them cautiously, especially if your child is high-risk.

Book Resources You Should Try:

• Caring for Kids: The Complete Guide to Children's Health, Edited by Norman Saunders, MD, FRCPC and Jeremy Friedman, MB.ChB
• Happiest Baby on the Block by Harvey Karp, MD,
• Secrets of the Baby Whisperer: How to Calm, Connect, and Communicate with Your Baby, by Tracy Hogg
• The No-Cry Sleep Solution. Pantley, E. (2002).
• The baby Sleep Book. Sears, W. at al. (2005).
• Solve Your Child's Sleep Problems, Ferber, R. (2006 - updated version of 1986 book)
• 1-2-3 Magic: Effective Discipline for Children 2-12, Thomas W. Phelan
• Honey I Wrecked the Kids, by Alison Shafer