Teen disease prevenmtion/Facts about bottle feeding

What's involved with teen disease prevention?

The teen years are a time of growth that involves experimentation and risk taking. For some teens, the social pressures of trying to fit in can be too much. These years can be even more troubling for teens who are confronted with teenage pregnancy, substance abuse, violence, delinquency, suicide, depression, unintentional injuries and school failure. Parents often walk a tightrope between allowing their teenager to gain some independence and helping them to deal with their feelings during this difficult and challenging time in their lives.
Teenagers recognize that they are developmentally between child and adult. Emerging cognitive abilities and social experiences lead teens to question adult values and experiment with health-risk behaviors. Some behaviors threaten current health, while other behaviors may have long-term health consequences. The changes in cognitive abilities offer an opportunity to help teenagers develop attitudes and lifestyles that can enhance their health and well-being. Teen disease prevention includes maintaining a healthy diet, exercising regularly, preventing injuries, and screening annually for potential health conditions that could adversely affect teenage health.

Health checkups

Annual checkups for teenagers provide an opportunity to

• promote healthy lifestyle choices which include nutrition, exercise;
• screen sexually active teenagers for sexually transmitted diseases (STDs);
• screen sexually active teens at risk for HIV infection;
• assess whether teen has an eating disorder such as anorexia nervosa, bulimia, or obesity. This assessment is reached by determining weight and stature, and asking about body image and dieting patterns;
• discover if teenager is experiencing emotional problems such as depression or anxiety;
• screening for depression or suicide risk for teens who have declining grades, chronic melancholy, family dysfunction, physical or sexual abuse , alcohol or drug abuse or previous suicide attempt;
• ask teenager if they have a history of emotional, physical, and sexual abuse;
• discuss health risks of smoking, alcohol abuse, and other drug abuses;
• ask teens about learning or school problems to determine if they need special counseling;
• screen teenagers who have a history of absences or declining school performance for dyslexia, learning disabilities, or attention deficit hyperactivity disorder;
• identify signs and symptoms of disease, illness and health conditions;
• screen for high blood pressure;
• test teenagers cholesterol level if their parents have a serum cholesterol level greater than 240 mg/dl;
• screen teenagers who have multiple risk factors for future cardiovascular disease (for example, smoking, high blood pressure, obesity, diabetes mellitus, excessive consumption of dietary saturated fats and cholesterol) for total serum cholesterol level;
• assess health-risk factors for overweight teenagers to determine their risk for future cardiovascular disease.

• Immunizations

  
  This is the immunization schedule as recommended by the federally convened Advisory Committee on Immunization Practices and Centers for Disease Control and Prevention (CDC).
  
  • Teens should receive a trivalent Tdap vaccine booster at the 11-12 year visit if not previously vaccinated within five years. With the exception of the Tdap booster at 11-12 years, routine boosters should be administered every 10 years.
  • Teenagers should receive a second dose of MMR at 11-12 years of age, unless there is documentation of two vaccinations earlier during childhood. The first vaccination is generally given at 1 year of age. MMR should not be administered to pregnant teens.
  • Teens, 11-12 years of age, who have not received their second Varivax vaccination as part of a routine childhood schedule and who do not have a reliable history of chickenpox should receive this booster vaccination. The first dose is generally given at 1 year of age.
  Most infants complete their immunization series against hepatitis B by their first birthday. If not completed, this should be accomplished by teens 11-12 years of age. Hepatitis A should be given to teens who are traveling or living in countries with high or intermediate hepatitis A virus (HAV), live in communities with high rates of HAV, have chronic liver disease, are injecting drug users, or are males who have sex with males. Complete immunization requires two vaccinations separated by a minimum of six months.
  Meningococcal vaccine—All teens 11-12 years of age should receive a onetime only vaccination to prevent meningococcal diseases (meningitis, general body sepsis, etc). Of note, this has become a mandatory vaccination for college.
  Female teens should be immunized against human papillomavirus (HPV). HPV is the leading cause of cervical cancer and genital warts. Three vaccinations over a six-month period are necessary for maximum protection.
  Annual vaccination against influenza is recommended for all teens.
  Teen Suicide Warning Signs
  
  Recognizing teen suicide warning signs
  Suicide is alarmingly common. It is the eighth leading cause of death for all people (accounting for about 1% of all deaths) and the third leading cause of death for people aged 15 to 24 (following accidents and homicide). The vast majority of suicides are related to emotional or psychiatric disorders, including depression, schizophrenia, bipolar disorder, and others. Unsuccessful suicide attempts also are common and outnumber actual suicides.
  While boys are more likely than girls to commit suicide, teens of both genders and all ages are at risk for suicide. It is especially tragic that the three leading causes of death in teens and young adults -- accident, homicide, and suicide -- all are preventable. Parents of teens should be aware of some of the warning signs of depression and suicide. The American Academy of Pediatrics describes the following signs that may signal that a depressed teen may be considering suicide...
  
  
  • withdrawal from friends and family members
  • trouble in romantic relationships
  • difficulty getting along with others
  • changes in the quality of schoolwork or lower grades
  • rebellious behaviors
  • unusual gift-giving or giving away own possessions
  • appearing bored or distracted
  • writing or drawing pictures about death
  • running away from home
  • changes in eating habits
  • dramatic personality changes
  • changes in appearance (for the worse)
  • sleep disturbances
  • drug or alcohol abuse
  • talk of suicide, even in a joking way
  • having a history of previous suicide attempts
  If you're concerned about how to help a depressed teen, don't be afraid to talk to him or her about the problem. It can help to reassure them that they are loved and that you are available to help work out any problems. Be a good listener, don't judge, and don't dismiss any of your teen's concerns. It's OK to directly ask if he or she has ever thought of killing him or herself. If you suspect your teen is suicidal, seek professional help immediately. Ask your pediatrician or family physician for recommendations for treatment programs.
  Remember: Threats of suicide or preoccupation with suicide are a medical emergency and should never be ignored.

• Options for Baby Bottles

  Should you opt for glass or plastic baby bottles? Your baby may give clues to which he likes best. Some things to consider: Plastic bottles are lighter than glass and are shatterproof. But some parents may want to avoid a chemical called bisphenol A (BPA) that is used in some plastic bottles. If so, look for plastic bottles that say "BPA-free
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• Baby Bottle Nipples

  Most nipples are made of silicone or latex and come in various shapes. They sometimes have different "flow rates," which correspond to the size of the nipple's hole. You may want to try several types of nipples to see what your baby likes best. Check nipples regularly for signs of wear or cracking, and replace any ones that are worn or discolored, because they may pose a choking risk
  
  

• Sterilize Bottles Before First Use

  Before using baby bottles or nipples for the first time, sterilize them in a pot of boiling water for 5 minutes. After that, you can wash bottles and nipples with detergent and hot water -- by hand or in the dishwasher -- each time you use them to feed your baby.
  
  

  Stick to Breast Milk or Formula

  Give your newborn only pumped breast milk or formula in the bottle -- no water or juice. Mix formula exactly as noted on the formula label. Adding too much water thins the formula, skimping on nutrition. Too little water may be harsh for your baby's stomach and kidneys.
  
  

  Choosing a Formula

  Most parents start with formula made from cow's milk. Soy formulas and hypoallergenic formulas are also available. If your baby is younger than 1 year, make sure you use an iron-fortified formula. You can buy formula in powdered, concentrated, or ready-to-use forms. On average, your baby should take about 2.5 oz. of formula each day for every pound he weighs.
  
  

  Warming Formula

  It's fine to give your baby a cool or room temperature bottle. If he prefers warm formula, place the filled bottle in warm water or run hot tap water over the bottle for one to two minutes. Don't put the bottle in the microwave; it can create hot spots that could burn your baby's mouth. Shake the formula and put a drop on the top of your hand to test the temperature. Don't test it on your wrist; it's less sensitive to heat.
  
  

  How to Hold Baby

  Put a bib on your baby and have a cloth ready to clean any spit-up milk or formula. Now, cradle your baby with his head a bit higher than the rest of his body. Hold the bottle; don't prop it up by itself. This can help prevent choking, extra gas, tooth decay, and provide bonding time. It'll also help you better judge when he's finished eating. If your baby slows his eating, try burping after every 2 oz.
  
  

  How Do You Know When Baby's Done?

  Your baby will let you know when she is finished feeding. She may stop sucking, turn away from the bottle, or, if she's old enough, push the bottle away. You may want to give her a chance to change her mind, but don't force her to finish what's in the bottle.
  
  

  How to Burp Your Baby

  If your baby needs a burp, during or after feeding, hold her on your lap or rest her on your shoulder. Gently pat or rub baby's back. You can also lay baby tummy-down on your lap, supporting her head, while you pat her back. Your baby may spit up some milk, so have a cloth on your shoulder or lap. If she doesn't burp after a few minutes but seems comfortable, don't worry. Not every baby burps after every feeding.
  
  

  How Long Can You Store Milk?

  Formula left over in the bottle should be thrown out. Immediately refrigerate opened packages of liquid formula and extra mixed formula to use within 48 hours. If left out more than two hours, trash it. Don't mix big batches of formula. Make it as needed. Refrigerate breast milk for use within 24 hours. Or freeze it. It can last up to four months in a standard freezer, or up to six to 12 months in a deep freeze of 0 degrees or colder.
  Introducing Baby To Solid Food
  
  
  Foods are usually (but not necessarily) introduced in the order shown below, with several weeks between different types of foods. Ages of introduction are approximate and may vary with individual babies. The baby's doctor is the best source for advice on when and how often any particular food is appropriate for that baby. Cereals should be mixed with formula or breast milk.
  

  Age	Food	Frequency
  4-6 months	precooked baby cereal baby juices	twice a day between meals
  5-6 months	strained single fruits	twice a day
  6-7 months	strained vegetables	once a day
  7-8 months	strained meats plain yogurt baby juices	once a day once a day between meals
  8-9 months	egg yolk, strained	once a day

  
  Babies under 1 year get most of their vitamins and minerals from formula or milk. When solid foods are introduced they are to supplement, not replace, milk or formula. Only gradually should solid foods become major sources of nutrients.
  Solid foods can usually be introduced between four and seven months of age. Early solids should be plain and introduced gradually one at a time, starting with iron- fortified infant cereals, progressing to pureed vegetables, fruits, and finally meats. The texture of solid foods fed to the infant will vary depending on age and individual ability. By the end of the first year, chopped table foods should be the basis of the diet. Adequate nutrients should be provided for normal growth and steady-but not excessive- weight gain. The amount should be regulated by the infant's appetite, provided that the growth rate is normal.
  Source: Food and Nutrition Board, National Academy of Sciences-National Research Council (www.cfsan.fda.gov)
  Breastfeeding and Formula Feeding
  
  
  A flood of questions and concerns arises upon confirmation of pregnancy. Certainly one of the important ones is "How will we feed our baby?" In this article, we will review advantages and disadvantages of breast and formula feeding and helpful concepts in preparation for breastfeeding. This article is intended to help parents feel comfortable in making an educated decision about feeding their child based on scientific information.
  
  

  When should we decide about breastfeeding?

  
  Generally, it is a good idea to meet with the baby's doctor prior to the birth in order for all to get to know each other in a controlled, non-rushed, quiet environment. This is a perfect opportunity to discuss your concerns and wishes about feeding your baby. One important reason to have the decision to breastfeed made before the delivery is that it can be very difficult or even impossible to start using formula and then later try to switch to breastfeeding. This is because the ability of the breasts to produce milk diminishes soon after childbirth without the stimulation of breastfeeding.
  
  

  Why is the choice so important?

  
  During your baby's first year of life, he/she will more than triple his/her total body weight, and the vast majority of this weight gain will come from the milk that he/she drinks. According to the American Academy of Pediatrics, human milk is the preferred feeding for all infants. This includes premature and sick newborns, with rare exceptions. Of course, breast milk would appear to be the most ideal food for your newborn. It is the food least likely to cause allergic reactions, it is inexpensive, it is readily available at any hour of the day or night; babies accept the taste readily; and the immunity factors in breast milk can help the baby fight off some infections.
  Although breast milk is the ideal food for human infants, because of medical or other reasons, some women opt for formula feeding. Infant formulas have been developed to artificially duplicate human milk, although no formulas have been developed that are an exact replacement for human milk.
  
  

  What are the advantages and disadvantages of breastfeeding?

  
  The nutritional advantages of breast milk are certainly numerous. The amino acids in breast milk, the building blocks of proteins, are well balanced for the human baby, as are the sugars (primarily lactose) and fats. The baby's intestinal tract is best aided in its digestion by the vitamins, enzymes, and minerals found in breast milk. Breast milk also contains infection-fighting antibodies from the mother, and breastfed babies are believed to be at a reduced risk for many acute and chronic infections early in life. The cholesterol content is also high in human milk and very low in formulas. Cholesterol promotes brain growth and provides the building blocks of hormones, vitamin D, and intestinal bile.
  Breast milk is also the least expensive way to feed an infant. However, the mother must maintain good nutrition and continue taking any vitamin/mineral supplements her doctor recommended during the pregnancy.
  Formula-fed babies also have the risk of developing an allergy to a particular formula. When a baby develops an allergy to formula, he or she may have symptoms that include irritability, crying after feedings, nausea, vomiting, diarrhea, or a skin rash.
  Nursing helps most women lose weight (though not fluid) after delivery, as 500 calories or more are used by breastfeeding each day.
  There is a well-accepted extra closeness that breastfeeding mothers experience that is both hormonal and emotional in nature.
  The only disadvantages for the baby in breastfeeding occur when things are not going well, for example, if there's an inadequate supply of breast milk or an inefficient suck reflex in the baby. However, it is unusual for a mother not to produce enough milk for her baby unless she is not breastfeeding correctly or frequently enough. The disadvantages that most commonly arise involve the rest of the family. Siblings and dad often feel "left out" of baby care since mom is the only one who can do the nursing. However, other family members can be involved in helping with different aspects of the baby's care, and this gives them a valuable feeling of importance and allows mom a chance to rest.
  Breastfed babies eat more often than formula-fed babies since breast milk is more quickly digested and leaves the stomach empty more frequently. This puts a little more stress on the mother because of the potential necessity for more frequent feedings. If the mother develops certain medical conditions, whether or not to continue breastfeeding may need to be reassessed. These conditions should always be discussed with the doctor. However, it is rare that breastfeeding would need to be discontinued completely. In any interaction, the mother's doctor and/or pharmacist should be informed that she is breastfeeding. Some medicines should be avoided during breastfeeding. Numerous other medications have not yet been adequately studied in the context of breastfeeding and the possible effects on the baby. If a breastfeeding mother is required to take a medication which has not been fully studied, she may want to consider discussing this matter with her doctor
  
  
  

  What are the advantages and disadvantages of formula feeding?

  
  For some parents, or when the baby has certain medical conditions, it is very important to know exactly how much their baby is receiving at each feeding, and formula/bottle-feeding allows exact measurement. Foods, medications, or physical conditions in the mother are no longer a concern for the baby who is receiving formula. The entire family can immediately become intimately involved in all aspects of the baby's care, including feedings, allowing the mother to get more rest. Formula-fed babies actually need to eat somewhat less often since formula is less readily digested by the baby than human milk. The disadvantages of formulas are primarily their expense, the lack of maternal infection-fighting antibodies that are in breast milk, and the fact that no formula can exactly duplicate the ideal composition of breast milk.
  
  

  Can we use both forms of feedings for our baby?

  
  According to the American Academy of Pediatrics, exclusive breastfeeding is ideal nutrition and sufficient to support optimal growth and development for approximately the first six months after birth. Furthermore, it is recommended that breastfeeding continue for at least 12 months, and thereafter for as long as mutually desired. Infants weaned before 12 months of age should not receive cow's milk feedings but should receive iron-fortified infant formula.
  Supplementing breastfeeding with formula is usually discouraged, although it may be helpful in cases where the mother is not producing an adequate supply of milk or the baby is not able to breastfeed well.
  Lactation aids are also available as an option to avoid using a bottle when supplementation is necessary.
  
  

  Is there any special preparation required for breastfeeding?

  
  Education about the benefits and practice of breastfeeding are keys to optimal preparation. Your local hospital may offer breastfeeding classes as part of the childbirth class, or you can join your local La Leche League or other breastfeeding support group. These classes can put you in touch with a lactation specialist who may later be your personal breastfeeding consultant. These classes can also help you to learn proper positioning and latch-on techniques.
  Contrary to some popular beliefs, it is not necessary to stimulate or prepare the nipples in advance for breastfeeding. Moreover, some techniques of stimulating the nipples may actually be harmful.
  No specific physical preparation is necessary for optimal breastfeeding. General good health measures and adequate hydration are helpful measures. Most doctors recommend continuing basic prenatal vitamins while breastfeeding.
  

  When can breastfeeding begin?

  
  Breastfeeding can begin within minutes after birth for most babies. Most babies take a few licks or sucks and then pause at the beginning. Frequent bursts of sucking interrupted by pauses is the usual pattern for the first few hours and sometimes even the first few days.
  The first milk the mother produces, called colostrum, is the best food for a newborn. The nipple stimulation that occurs during breastfeeding also helps the uterus contract and can help stop uterine bleeding.
  When a baby begins to open its eyes, look around, and put his or her fist into his or her mouth, then it is time to offer your breast. Breastfeeding experts recommend that the baby not be given sugar water or other types of bottle feedings in the hospital unless specifically prescribed by the doctor.
  
  

  What is the proper technique for breastfeeding?

  
  Observing other breastfeeding mothers and talking with breastfeeding support organizations can help new breastfeeding mothers learn techniques for optimal breastfeeding that can help reduce the likelihood of any discomfort or complications. These techniques are briefly outlined below.
  After the mother has assumed a position comfortable for her, she can nestle the baby in a cradle hold (cradling the baby with the mother's arm on the same side as the breast being presented). The baby's body should be on its side, so that the baby does not have to turn his or her head to reach the nipple.
  
  1. First, manually express a few drops of milk to moisten the nipple. 2. Cup the breast with your hand and using the milk-moistened nipple, gently massage baby's lips, encouraging the baby to open its mouth. 3. When the baby's mouth is opened, the nipple is inserted into the center of the baby's mouth while pulling the baby in very close. The baby's gums should take in at least a 1-inch radius of the areola. 4. The mother may have to make adjustments for the baby's breathing by changing the angle of baby's position slightly or using the thumb to press gently on the breast to uncover the baby's nose. 5. Hold the breast throughout the feeding so the weight of your breast does not tire your newborn's mouth. 6. When feeding is over, to avoid trauma to your nipples, do not pull your nipple from baby's mouth without first breaking the suction by inserting your finger into the corner of baby's mouth

  How can one manage minor discomforts related to breastfeeding?

  Clogged milk ducts

  Clogged milk ducts may appear as small, red, tender lumps within the breast. Milk ducts may become clogged with dried milk or other material. The goal of treatment is opening these blocked ducts. This can be aided by increasing the breastfeeding frequency and offering the affected breast first, as well as pumping the breast after breastfeeding if the baby is not emptying the breast. Moist heat packs can be applied to the affected area to increase blood flow and healing. A warm shower and massaging of the area may also enhance resolution of this problem. Sometimes, the baby will refuse the affected breast because the milk develops a sour taste. Pump the breast and empty it as well as possible. Continue to offer that breast to the baby until he/she accepts the affected breast again.

  Sore nipples

  Sore nipples can be relieved by exposing the nipples to the air as much as possible. Using a hair dryer on a low setting to dry nipples after breastfeeding may also provide relief. Nipples should be washed only with water, never with soap, alcohol, benzoin, or premoistened towelettes. Petroleum-based ointments and other cosmetic preparations should not be used, but unmedicated lanolin may help alleviate nipple cracking.

  When should one seek medical care for problems with breastfeeding?

  It is important to call your health-care provider if the above techniques do not alleviate the problem or if you develop serious symptoms such as fever or signs of mastitis (a breast inflammation that may be caused by an infection). Symptoms of mastitis include increasing pain in the breast, fever, chills, sweats, breast swelling and/or hardness, and redness of the skin over the affected area. A delay in treating mastitis could lead to a more severe infection and possible breast abscess.

  Can supplements or medications increase a low milk supply?

  
  Most experts agree that increasing the number of feedings and receiving coaching and assistance on proper breastfeeding technique can help increase what is perceived to be a low milk supply. Some women find that using breast pumps after each feeding stimulates milk production because of the increased degrees of emptying of the breast.
  Medications that are reported to increase milk production are known as galactogogues. The most common examples are dopamine receptor antagonists (such as metoclopramide [Reglan, Reglan ODT, Metozol ODT, Octamide] and domperidone). However, there have been no data to demonstrate that these drugs are more effective than interventions that focus on improving breastfeeding technique and increasing breastfeeding frequency. Most doctors do not support the use of these medications to augment milk supply.
  Likewise, a number of dietary supplements and/or herbal preparations have been claimed to stimulate milk production, including alfalfa, fenugreek, or blessed thistle. There is no scientific data to support the claims that any herbal or dietary supplement can increase milk production.
  
  

  Is it possible to breastfeed while pregnant?

  
  While breastfeeding typically is associated with a decrease in fertility, it is possible to become pregnant while breastfeeding, and breastfeeding does not afford 100% protection from pregnancy. For most women, it is safe to continue breastfeeding if they desire, provided they ensure that they are receiving adequate nutrition and fluid intake. While breast milk from a pregnant mother is still nutritionally strong, the hormonal changes of pregnancy will result in some changes in the content of the breast milk and the way the breast milk tastes.
  Some women who have had premature labor in previous pregnancies may be advised to stop breastfeeding if they become pregnant. This is because the stimulation of the nipples that occurs during breastfeeding may trigger contractions of the uterus. In a woman prone to preterm labor, these weak uterine contractions might increase her risk of developing preterm labor. Both pregnancy and breastfeeding place high demands on the body in terms of nutritional support and rest. Other women may be advised to stop breastfeeding during pregnancy if their nutritional status is poor or if they are suffering from extreme fatigue due to the pregnancy
  
  
  
  
  
  
  
  
  
  
  
  source:medicinenet.com