According to the American Academy of Pediatrics (AAP), “All healthy infants beginning during the first two months of life , children and adolescents should receive vitamin D supplementation to prevent rickets and vitamin D deficiency.” Rickets is a bone-softening disease caused by insufficient exposure to sunlight and inadequate vitamin D intake. An infant may be severely vitamin D deficient months before it is apparent upon physical exam.

Sunlight can be a major source of vitamin D, but sunlight exposure is difficult to measure. Factors including the pigment in your baby’s skin, and skin exposure affect how much vitamin D the body produces from sunlight.

Exclusively breastfed infants are at increased risk of vitamin D deficiency and rickets. This is because human milk contains only small amounts of vitamin D, which may be insufficient to prevent rickets. This should NOT discourage breastfeeding. Providing a vitamin D supplement for your infant can supply the necessary daily dose. Babies who are largely formula fed (ie; they are drinking at least 17 oz. of formula daily) should be able to get their daily intake of vitamin D from formula. All infant formulas that are sold in the United States contain a sufficient amount of vitamin D. For breastfed infants, vitamin D supplements are available in an over the counter liquid form as part of multivitamin preparations (such as Poly-Vi-Sol by Enfamil). The usual dosage is 1 cc (or ml) per day. Continue this daily until your baby is at least one year of age.

Constipation is a condition where stools become firmer and harder than normal and your infant may have difficulty and/or pain when they need to have a bowel movement. Constipation is also marked by infrequent bowel movements.

A breast fed baby will rarely become constipated because breast milk is easily digested. A baby who is formula fed however, may suffer occasional bouts of constipation. It is common for a formula fed infant to have fewer bowel movements than a breast fed baby. An infant can go up to a week without having a bowel movement and still be “within normal limits.” As long as your baby is not in pain or significant discomfort trying to have a bowel movement, this is considered completely normal. If your baby does seem to be in pain while trying to pass stool, please give our office a call so that we may guide you through some steps to offer relief. Also, if you are noting a persistent amount of spitting or vomiting associated with apparent discomfort, it is important to call us for further advice.

It is now recommended that all infants be placed on their back or side while sleeping to reduce the risk of Sudden Infant Death Syndrome (SIDS). Because of this, however, infants spend little to no time on their stomachs. It is extremely important that you give your baby time on his/her stomach every day while they are awake to allow for proper muscle development and to prevent the head from becoming misshapened.

It is recommended that you place your baby on their stomach on a firm surface, such as the floor, for five to ten minutes 2-3 times a day. This will allow your infant to begin to practice developing their neck and upper body muscles. This will also allow them to have some time off of the back of their head, thereby minimizing the flattened area on the back of the head. Your baby will most likely be very unhappy with tummy time in the beginning. Start out with a couple of minutes a day and gradually work up to the time stated above. Between 2-3 months of age your baby will be able to lift their chest off the floor to about their nipple line. Once they can do this your baby should become much happier with tummy time. Try placing toys and mirrors in front of your baby to help entertain them.

At or about one month of age, your baby may be doing the following things:

• Raises head slightly off floor or bed while on stomach
• Holds head up momentarily when supported
• Briefly watches and follows objects with eyes
• Begins to smile in response to a parents voice or face