Doctor Kozlova: what a baby should eat and where he can rest

Interview by Vladimir Nesterov. Exclusively for Vestnik Kavkaza
Doctor Kozlova: what a baby should eat and where he can rest

Vestnik Kavkaza continues the series of programs ‘Ask Doctor Kozlova.’ The Honoured Doctor of the Russian Federation, Honored Worker of Science, Professor, MD, the deputy chair of the Federation Council on Social Policy, the senator from the Smolensk Region, Lyudmila Kozlova, answers questions of TV viewers, radio listeners and readers.

- So, a new program, a new stack of letters. A young mother writes: I have a 5-month-old baby, I want to fly to Egypt in October-November, they tell me that such a climate change is undesirable for children of this age. And air travel too. At what age can a baby travel to warm countries?

- According to the opinion of pediatricians, from the age of three. But we see that when we go on vacation, parents take their children with them from an early age. I believe that you should go only if it is necessary. If you must move somewhere, for example, because of a child's father-serviceman. And it's better to rest in the group in which the child was born and where his parents live. If this is the middle band, then in the middle zone, if the south, then in the south. But I would not recommend you to change the climate at such an early age. The heat in Egypt causes stress even among adults. And you should take into account the baby's eating habits.

If parents want to take their child on vacation, it is necessary to imagine how difficult this journey would be for a baby: the heat, the long distance, the long time flight, especially taking into account waiting in the airport, registration, the road to the hotel, accommodation. A baby cries, not knowing where and why he is being taken. He will be fine everywhere with his parents, clean air and the ability to run on the land or grass and where there is no long road.

- My baby is two months old. His temperature is almost 39°C. There are no signs of disease, the doctor said, and it is more likely because of his teeth. Can teeth erupt at two months?

- It can happen, but it's a rare thing. In this particular case, I would not say that the reason for the high temperature of a two-month-old baby is the teeth. Maybe this parents did not quite understand the doctor. It is necessary to rule out other possible causes to associate the appearance of a high temperature with teething. A 39°C body temperature would rarely appear during teething. The immune system of baby during teething is low, so a child can become ill with an intestinal infection, a respiratory viral infection, inflammation of the middle ear may appear if the respiratory tract is affected.

So what you should do is ventilate the room, the temperature should be no higher than 22 degrees, give him a febrifuge. If the baby's hands or feet are too warm, you can rub them with alcohol. When a baby's hands or feet are too cold you absolutely cannot rub them with alcohol. And you must call a doctor, as the diagnosis and treatment is his prerogative.

- Do I need to bring down the temperature during his first teething?

- The temperature should be reduced if it is above 38.5 degrees. Because a high temperature may cause convulsions. These are so-called febrile (temperature) convulsions. In some cases we recommend reducing a temperature which is higher than 38°C. And, of course, you need to call an ambulance. The doctor will look at your baby and solve all the problems. Parents wanting good for their child are often engaged in self-medication. This is the most harmful thing. The prescription of medicine is a doctor's prerogative.

- There are special toothpastes for kids. How effective are they?

-  These toothpastes are different – for example, toothpaste which gives a cooling effect. It relieves pain, but not completely. It relieves suffering, but only for a certain period of time. Such toothpastes should be used when there is strong pain. You can use different tools – rings to scratch and bite gums to facilitate teething.

- And now about breastfeeding. If a young mother is nervous that breast milk has gone away, what can she do?

- There is such a thing as lactation crises. Maybe it is such a period. She didn't write about the child's age. The amount of breast milk may decrease when a baby is only 2-3 weeks, but also between 3 and 5 months of age.

- A question on the subject: "I have a lactation crisis, my baby is 2.5 months, and I cannot get enough milk from both breasts, I want to keep feeding, so how can I stimulate milk supply?"

- In times of lactation crises the amount of milk may significantly decrease, so do not be afraid, you need to understand that everything can return, and you will feed. To do this, you must calm down, drink fluids, eat vegetables and fruits. Balanced nutrition of a breast-feeding mother should include meat, fish, but she needs to eliminate spicy foods, spices, she should cook using water or steam. And take walks. Milk may reduce when a woman is tired, when she doesn't have enough sleep, it's natural. She cannot smoke and drink alcohol. But if she puts the baby to her breast often, it stimulates lactation.

- Can a mother feed her baby if she has milk stagnation and a raised temperature of 38-39 degrees?

- She can, she even must do it. A mom's temperature can be caused by stagnation. If some mother falls ill, it is necessary to feed in a mask, and if a mom doesn't feel good, she should feed her baby with expressed breast milk. Do not feed only if the mother is in a critical condition or in case of infectious diseases.

If the stagnation of milk led to a rise in temperature, it is necessary to put the baby to your breast. No one can cope with congestion better than a baby. If the baby does not want your breast milk, you should pump it first and then put the child on. That's all.

- How best to keep breast milk if the mother has to work – to freeze it or keep it in the refrigerator?

- It is necessary to decant the milk into a clean boiled bowl and leave it in the refrigerator.

- The next question is about artificial feeding. How to know what is the safest composition of formula milk?

- The formula milk recommended by doctors is safe. When choosing a formula milk it is always necessary to look at its composition and the evidence base of efficacy and safety. The doctors know this, they should make recommendations on the selection of formula milk. I am very pleased that competitive domestic formula milk has appeared. Imported formula milk is also good. We have had it on the market for a long time. Therefore, in choosing a formula milk, you should ask a doctor.

- A baby spits up strongly after feeding. How long should I hold the baby upright?

- You should hold a baby in an upright position for at least 20 minutes after the feeding of the child. If he still spits up, you can feed him once more.

- A baby is interested in adult food: cheese, sausage, butter. At what age can he try it?

- I would not recommend sausages even for adults, not just children. Take a piece of meat, boil it, or you can bake it in the oven without spices. A baby can begin to eat meat from 6-7 months of age in the form of chopped meat, especially if the child has a tendency to anemia, when the baby's hemoglobin level is lower than normal. A baby already receives butter from cereals and vegetable puree. First, we give three grams, then five grams. If we talk about sandwiches, then you should give them after three years. Sandwiches are not a harmless thing. As for cheese, you can give it to a baby after one and a half years. First, 5 grams per day, gradually increasing to 20 grams. As a separate dish – from the age of three.