Infant Series: FAQs

Red Crystals in the Urine
This is a common finding more common with breastfeeding and represents urate crystals in the urine. These resolved spontaneously and do not require and treatment.

Vitamin D
New recommendations have come out for all babies to receive at least 200 IU of vitamin D each day. Vitamin D deficiency can cause a condition known as Rickets where the bones do not grow properly. Vitamin D in addition to in food, can also be made by the skin through skin exposure. Rickets historically has been prevalent in underdeveloped countries but after cases of rickets started showing up in the US, the AAP recently changed their recommendations for supplementation.

Formula (at least 16 ounces per day) is fortified with vitamin D and meets the daily requirements. If your baby is breastfeeding exclusively, they should receive supplemental vitamin D 400 units per day. This can be obtained with a liquid multi vitamin called polyvisol (1 dropper per day), available at all pharmacies, given straight or mixed with breast milk in a bottle.

Swimming
We recommend infants can start swim classes only after 2 months or after their first set of immunizations.

Planes
The major risk with flying has to do with exposure to crowded places and sick people. We do not recommend taking your baby on a crowded plane before 2 months. Any time after that, we would consider it safe. Just remember to feed on the way up and the way down to keep the eustachian tubes open. Benadryl can be used safely after six months to assist in sleep. (see Benadryl dosing).

Ears pierced
We recommend ear piercing only after 3 months of age.

Pacifiers
We have no objection to pacifiers as they usually cause no feeding issues and can be a source of comfort for those infants with a strong oral fixation. The earlier you can wean off the pacifier the easier and you should have you baby weaned off by 18 months.

Hiccups/Sneezing
Both hiccups and sneezing are normal newborn reflexes that are common, and both resolve with time. No treatment is required.

Temperature
We do not recommend taking your babies temperature regularly unless they have symptoms such as feeling hot, crying without a clear cause or irritability. We would recommend buying a normal digital thermometer (same as for adults). In the first 6 weeks, a temperature should be taken rectally, and a fever is anything equal to or greater than 100.4 degrees. This needs evaluation in the hospital for a bacterial infection. The reason a rectal temperature is needed is because this is the gold standard and greatly affects management. After 3 months of age, an underarm measurement or ear measurement is adequate.