Diapering Your Growing Baby

By Betsy Riley
WebMD Feature

Reviewed by Hansa D. Bhargava, MD

At around 24 months, your child may be gaining the language and physical skills needed to start toilet training. But diapers are still a fact of life for most young children at 2 and beyond. Here’s what you need to know to master this new stage of diaper duty.

Diaper size can change quickly. Before you stock up at the wholesale club, make sure you’ve got the right size. Children grow at such different rates that weight is better than age for judging the right size diaper, says Filer.

During baby's first year -- when you're visiting her doctor all the time -- add her latest weight to your memory or smartphone.

If you’re not sure about your toddler, lead her to your home scale. If she won’t stand still on the scales, weigh yourself and then weigh again while you’re holding her. A little subtraction will give you a rough idea.

Don’t ignore dirty diapers. Let’s face it, you’re probably more relaxed than when you brought your baby home from the hospital. If a wet diaper’s not bothering your child, it’s awfully tempting to leave it just a little longer. “Who of us hasn’t seen a droopy diaper on a toddler and said, ‘That can wait another half hour’?” says Lisa Asta, MD, a pediatrician and spokesperson for the American Academy of Pediatrics.

Of course, even though the absorbent gel keeps liquids away from your toddler’s bottom, a wet diaper can still cause diaper rash.

Toddlers get less diaper rash. Fortunately, toddlers don’t get diaper rash as often as babies. Diaper rash peaks when babies are between 9 and 12 months old, partly due to the transition to formula and solid foods.

Attack a rash quickly. If your toddler does get diaper rash, treat it like you did when she was younger. Slather on plenty of ointment.  Watch for signs of infection like fever, ulcers, or a rash spreading outside the diaper. If you spot any of these, ask your doctor about medicine.

As always, wash your hands before and after every diaper change.

If you recently started using pull-ups, consider going back to diapers or switching to another brand, suggests Asta.

Choose the right changing location. A toddler may squirm too much for that cute little changing table in the nursery. It's not worth risking a nasty fall. Try using a changing pad on the floor, closer to the action, says Lucinda Brown, RN, spokesperson for the Society of Pediatric Nurses.

Remember to change your toddler in an appropriate place, though. You may be so used to poopy diapers that you may forget everyone around you isn’t.

Make diaper time fun. Toddlers have better things to do than get their diapers changed. “They’re at an age when they’re all about being oppositional,” says Asta. “It’s very developmentally appropriate, but, boy, it wears you out.” Brown suggests giving your child a toy to play with at changing time, or singing songs to distract her.

However, don’t make changing optional, Brown advises. “Don’t approach your child by saying, ‘Is it OK for me to change your diaper?’ There are lots of things you can battle with kids over, but changing a diaper isn’t one of them.”

source : Diapering Your Growing Baby

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A Challenge at Work Might Ease Autism Symptoms in Adults

Finding counters the notion that difficult behaviors are hard to alter in these patients

WebMD News from HealthDay

By Barbara Bronson Gray

HealthDay Reporter

FRIDAY, Jan. 31, 2014 (HealthDay News) -- For adults with autism, having the chance to work somewhat independently may lead to a reduction in symptoms of the disorder, a new study suggests.

The research puts new emphasis on the potential for adults with autism to develop and improve over their lifetimes, said study author Julie Lounds Taylor, an assistant professor of pediatrics at Vanderbilt University, in Nashville.

"We have assumed it's really hard to budge autism symptoms in adulthood. Drugs are targeted to problems like acting out, for example," she said. "But this study suggests that these adults need a place where they're intellectually stimulated, and then we'll see a reduction in symptoms."

The challenge is to find the right fit between a person's abilities and interests and a specific job, she explained.

"How independent can they be and what are the risks of failure? We have to be careful. You're talking about a huge range of people with autism," Taylor said. "I've seen people who can manage pretty high-level jobs, like computer programming or being in the military, while others have more [mental] challenges, but can still work a job in the community with support."

Autism spectrum disorders are a class of neurodevelopmental disorders defined by difficulties with social functioning and communication, according to the researchers. Symptoms include restricted interests, repetitive behaviors and difficulty with social interactions.

The study findings were reported online recently in the Journal of Autism and Developmental Disorders.

Increasing the level of independence in adults with autism isn't necessarily difficult to do, Taylor said. "We found behavior changes any time you could bump [them] up to doing something a little more independent," she said. "As they get more independent, you see more benefit."

Yet understanding what makes a good fit is a huge challenge, she said. "Insight is one of the characteristics people with autism typically may not have, so we will probably need the person's perspective and then gather information from families, looking at what's available, and incorporating all of that together," Taylor explained.

About 50 percent of adults with autism spend their time in sheltered settings, and a minority work in the community, according to Taylor. Most have trouble holding steady jobs, she added.

For the study, the researchers tracked the behavioral development and activities of 153 people with autism spectrum disorder over a five-year period. Their average age was about 30.

The data came from a larger study conducted at the University of Wisconsin-Madison, which followed 400 families with adolescents with autism over 10 years. Data were collected at two different points in time almost six years apart. Data came from the primary caregiver -- 150 were mothers and three were fathers.

source : A Challenge at Work Might Ease Autism Symptoms in Adults

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Postmenopausal Estrogen Therapy Tied to Lower Glaucoma Risk

Effect seen for women on estrogen-only treatment in study, but experts say more research is needed

WebMD News from HealthDay

By Kathleen Doheny

HealthDay Reporter

THURSDAY, Jan. 30, 2014 (HealthDay News) -- Women who take estrogen-only hormone-replacement therapy to relieve menopausal symptoms might also be reducing their risk for a common form of the eye disease glaucoma, according to new research.

"Ours is one of the first ... studies to find estrogen-containing hormone-replacement therapy was associated with a reduction in glaucoma risk," said study researcher Dr. Joshua Stein, an assistant professor of ophthalmology at the University of Michigan.

Other studies, however, have come up with conflicting results, Stein said. In his study, he looked at insurance-claims data for women aged 50 and older who were enrolled in a managed care plan for at least four years. The women visited an eye care provider at least twice from 2001 to 2009.

He evaluated information on more than 152,000 women, about 60,000 of whom had at least one prescription for estrogen-only therapy, he said. The others took a combination of estrogen and progesterone or estrogen plus an androgen (male hormone).

During the study period, about 2 percent of the women developed a common form of glaucoma known as primary open angle glaucoma, Stein said, which develops when pressure builds up in the eye. Glaucoma refers to a group of eye diseases that damage the optic nerve and can lead to blindness. Treatment can help preserve vision.

Each month of estrogen use reduced the risk of glaucoma by 0.4 percent, and that risk reduction accumulated over time, Stein said. After four years of continuous use, the reduction in risk would be about 19 percent, he said.

Although the researchers found an association between the use of estrogen-only therapy and a reduced risk for this form of glaucoma, they did not prove a cause-and-effect link. No link was found for the other hormone regimens.

The study was published online Jan. 30 in the journal JAMA Ophthalmology.

Estrogen might work by lowering the pressure or by protecting certain cells in the eye, the researchers said.

Hormone-replacement therapy has been linked with increased health risks, such as heart disease, breast cancer and stroke. One 10-year follow-up of the Women's Health Initiative estrogen-only trial, however, found a reversal of the health risks among women who'd had a hysterectomy.

The new study results do not suggest that reducing the risk of glaucoma is reason enough to take hormone replacement therapy, said Dr. Angela Turalba, a glaucoma specialist at the Massachusetts Eye and Ear Infirmary.

Rather, the findings may prompt drug companies to begin looking at estrogen as a glaucoma treatment, said Turalba, who reviewed the research. "The findings are most helpful in guiding research in drug development for hormone-based therapies to be used as neuro-protective agents," she said.

Stein agreed. He said the goal would be to encourage drug companies to develop topical estrogen derivatives and study them as a glaucoma-preventive therapy.

The focus of the study was on women, he said, so there is no way to know whether estrogen-based treatments would also help men reduce glaucoma risk.

source : Postmenopausal Estrogen Therapy Tied to Lower Glaucoma Risk

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