Children's Health | Mount Sinai Today

Why Does My Baby Cry So Much?

Updated on Oct 5, 2023 | Children's Health, Your Health

A fussy and crying infant can be a tremendous challenge for parents. Just when you get past the stress of childbirth, learn how to feed your baby, your newborn’s weight gain, and possibly deal with a jaundiced baby, your infant begins to spend more time awake, often fussing and crying frequently. Is your baby experiencing the dreaded colic or is something else wrong?

Jennifer Bragg, MD

In this Q&A, Jennifer Bragg, MD, Director, Mount Sinai Neonatal Intensive Care Unit Follow-Up Program, and Associate Professor of Pediatrics at the Icahn School of Medicine at Mount Sinai, explains colic, how parents can tell if their baby may have it, and what to do to soothe a fussy baby.

What is colic?

“True colic” is defined as at least three hours of unexplained crying or fussing, at least three days per week, for at least three weeks in a row. It often starts around two weeks of age, peaks at four to six weeks, and goes away by three to four months. These hours of crying usually occur at a certain time of day, often in the evening hours. When not crying, the baby is usually happy. The crying is often high-pitched and many babies will pull up their legs, almost as if in pain, or turn red in the face. It is equally common in boys and girls, and slightly more common in first-born children.

What causes colic?

It is not entirely known what causes colic. Some believe it is caused by immaturity of the nervous system, while others believe it is caused by something upsetting the baby’s stomach. The most conventional wisdom is that colic is caused by a combination of the two. What we do know is that colic has no ultimate impact on a child’s temperament and personality later in life. Studies have shown that a colicky baby is no less likely to be a pleasant, happy, and well-adjusted child, teenager, and adult.

My fussy baby does not have “true colic.” What else could cause their constant crying? Should I see my pediatrician?

There are many explainable reasons for crying in a baby. Hunger, fatigue, and a dirty or wet diaper are simple, easily fixed causes. There are also some treatable medical problems such as sickness, fever, or pain. Babies also may be particularly fussy if their stomachs are upset due to a food sensitivity or gastroesophageal reflux disease.

Crying accompanied by a fever, vomiting, diarrhea, or runny nose may indicate that your baby is sick. A food sensitivity may be the culprit if your baby’s stool contains blood or mucus or if there is excessive spit-up or vomiting even after switching formula or, if breast-fed, the mother has eliminated certain items (dairy, caffeine, etc.) from her diet. Gastroesophageal reflux disease may be suspected if the baby is upset and appears to be in pain during spit-up and shortly after feeding; this can be treated with medication. Addressing these potential underlying causes of your baby’s crying should curtail the fussiness.

What can parents do to soothe their baby?

To soothe the fussy baby, it may help to use a method that mimics the baby’s environment in the womb. They are often referred to as the 5 S’s:

Swaddling, which entails wrapping a baby’s arms tightly to the side
Shushing, or using white noise to relax your baby
Swinging or rocking your baby
Sucking on either the breast or a pacifier may calm your baby
Holding the baby in the side/stomach position with a small amount of pressure on their belly can also be helpful

There is no evidence that over-the-counter remedies such a simethicone gas drops or gripe water helps, but they are certainly safe to try and many parents find them beneficial.

If the above does not help, it is important to understand that the crying is not a reflection on parenting skills. If possible, take breaks from the task by seeking help from other family or friends. In time, the crying and fussing will get better.

If symptoms cannot be explained by any of the above, and the crying persists for hours per day and for days or weeks straight, parents should make an appointment with their pediatrician.

Learn more about Your Health.

Is Swimmer’s Ear Causing Your Child’s Ear Pain?

Jul 1, 2023 | Children's Health, Your Health

It’s the time of year when you and your kids may head to the pool to beat the heat. But for some people, swimmer’s ear may ruin the fun. Aldo Londino, MD, Assistant Professor of Pediatric Otolaryngology at the Mount Sinai Health System and Chief of the Division of Pediatric Otolaryngology at the Mount Sinai Kravis Children’s Hospital, explains the pesky condition, its treatment, and how parents can best guard against it.

What is swimmer’s ear and how would my child contract it?

Swimmer’s ear is the name commonly given to an infection of the ear canal, also known as acute otitis externa. This infection can happen at any time of the year but tends to peak in the summer months as people spend more time in the water. Lingering moisture in the ear canal after swimming can create an environment in which bacteria love to grow. Swimming can also wash away healthy ear wax that protects the ear canal from infections.

How is swimmer’s ear different than a ‘regular’ ear infection?

When people mention an ear infection, they are often speaking of a middle ear infection. Also known as acute otitis media, this is an infection behind the eardrum. It is often treated with antibiotics by mouth unless the child has ear tubes, is most common in very young children, and is often associated with an upper-respiratory-tract infection. A middle ear infection is not caused by bath water or pool water getting into the ears because the eardrum keeps the water from getting inside the body.

How do I know if my child has swimmer’s ear or a middle ear infection?

Children may have swimmer’s ear if they complain of pain and the ear canal has drainage or appears swollen. Often a light tug backwards and upwards on the outer ear will produce pain in the ear canal. Swimmer’s ear infections usually do not cause a fever.

Your child may have a middle ear infection if there is pain with a bulging ear drum on your pediatrician’s exam. There can sometimes also be drainage if the build-up of pus has leaked through the eardrum; however, the ear canal should not be swollen. Children with a middle ear infection also often have a fever or a cold associated with the infection.

Is the treatment for swimmer’s ear different?

Yes. Swimmer’s ear should be treated with ear drops alone. In fact, the ear drops often help faster and do a much better job at treating the infection than antibiotics taken by mouth. From time to time, the ear canal may be too swollen or have too much drainage for the ear drops to enter. A trip to the ear, nose, and throat doctor may be necessary in these instances to help remove excess drainage or place a small sponge in the ear to allow the ear drops to enter and work effectively. If your child is in pain, you can give them acetaminophen or ibuprofen.

What can I do to prevent my child from contracting swimmer’s ear?

If your child suffers from frequent swimmer’s ear, you may want to consider using earplugs to limit the amount of water getting into the ear canal. A hairdryer on a low cool setting after swimming can also help dry up excess water and reduce the frequency of swimmer’s ear infections.

Aldo Londino, MD, is an Assistant Professor of Pediatric Otolaryngology at the Mount Sinai Health System and is Chief of the Division of Pediatric Otolaryngology at the Mount Sinai Kravis Children’s Hospital.

Make an appointment with Dr.Londino

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What to Expect When You Need to Take Your Child to the Emergency Room

Jun 30, 2022 | Children's Health, Featured, Your Health

It’s a moment every parent dreads. You believe your child needs critical medical care and decide you must go to the hospital.

Christopher Strother, MD, Director of Pediatric Emergency Medicine at The Mount Sinai Hospital, offers some helpful tips on when you should take your child to the emergency room and how to best prepare. The Mount Sinai Hospital recently completed a full renovation of the Children’s Emergency Department, which features state-of-the-art technology and treatment rooms, and specially trained staff.

What are the most common pediatric emergencies?

For children, the three biggest things that we see in the emergency department are infections, such as the flu, stomach viruses that can cause patients to get dehydrated, and high fevers. That’s followed by injuries: falls, broken arms, cuts, and head injuries. In New York, we also see a lot of patients with asthma, especially during the spring allergy season.

When should you take your child to the emergency department?

It’s a tough question. Anytime your child is in pain, or you’re scared, or you’re worried about their safety, we’re here for you 24/7. We’re there for anything, and if you think you need to see somebody right away and you’re not sure where else to go. There are many reasons to come to the hospital, such as severe pain or injuries, or anytime you’re worried about your child’s health and safety. The things we worry the most about are trouble breathing, dehydration, and major injuries.

How does the children’s emergency room at The Mount Sinai Hospital differ from a regular emergency room?

The biggest difference in a children’s emergency room is the people who work there. The doctors and nurses are all pediatric trained and comfortable taking care of sick children. If your child needs medications, an IV, or a procedure, the people who do that are trained to do it with children. We also have child life specialists who will help kids cope with the experience. Our staff will help your child be comfortable. They can educate you and your child on what’s happening and what’s going be next. Our expertise, our staff, and our training and the focus on children really set us apart.

What else is new at the Emergency Department?

The new Emergency Department is tailored to the needs of children and their families, with a separate space from the adult ED that is connected to all services within Mount Sinai Kravis Children’s Hospital.

We’ve increased the size of the Department as well as redone the entire space. It’s brighter and very child friendly, with lots of colors and other features that make the experience calmer and safer for kids. Video tablets have something to keep kids busy, distracted, and calm. We have a whole wall with an interactive video for the kids to look at. It feels like a family environment. We’ve also created are a “low-stimulation room,” which is a single room a little bit apart for children with autism or other neurodevelopmental challenges, where they can be quiet and calm. We also have a separate area with the most advanced equipment where we can take the best care of critically ill children.

How common are children only emergency rooms?

We’re lucky here in New York. We have several children’s hospitals in New York City and around the area. A lot of places in the country don’t have any. A major city might have one children’s emergency department. Most children who go to the emergency department in the United States go to a general emergency department. Pediatric emergency departments are a unique thing.

What else does Mount Sinai offer?

Mount Sinai has two other pediatric emergency departments, one at Mount Sinai-Union Square downtown and one at Mount Sinai Morningside on the Upper West Side. At all of the emergency departments throughout Mount Sinai Health System, we keep in touch with how they take care of children. So even if you’re not in one of our children’s emergency departments, our pediatric specialists are working closely with the other emergency department to make sure that your child gets the best care.

What are some tips for parents taking their child to the emergency room?

If possible, call your pediatrician first. Sometimes you’re worried. Things may look scary, and you feel you must go right away. If you have a minute to think about it, I always suggest giving your pediatrician a call if you can. It helps in a few ways. Sometimes talking to your pediatrician or your regular doctor can actually keep you from having to go. Sometimes they can make an appointment the next day or give you some advice that might allow you to stay home for this visit.
Be prepared to spend some time in the emergency department. If you need to go, be prepared to be there for a while. Bring a charger for your phone, and a book. A visit may last a couple of hours. It can take time to perform X-rays or tests.
·Be ready to tell the medical staff about any medications your child is taking. Either bring the medications with you or write them down. It’s extremely helpful to the staff at the hospital to know what your child has taken already and when they took it. For example, if you have given Tylenol or Motrin, write it down. Let us know when was last time. Or if your child has any allergies to medications, let us know right away.
·Let us know as soon as possible if your child has any chronic medical conditions. For example, if your child has sickle cell disease, when you come into the emergency department with a fever let the first person you talk to know they have a fever and sickle cell disease. Because that can change the way we approach a patient and the tests that are done. Be up front and an advocate for your child’s history.

Read about the renovations of Mount Sinai Children's Emergency Department

My Child Has a Heart Condition. What Should I Do?

Updated on Jun 30, 2022 | Children's Health, Heart Health, Your Health

Becoming a parent is exciting, sometimes nerve-wracking, and comes with a heap of responsibility for the health and well-being of your child. And if your child has been diagnosed with a heart condition, anxiety can ratchet up due to the uncertainty of what the condition may mean for their future.

Robert H. Pass, MD, Chief of the Division of Pediatric Cardiology at the Icahn School of Medicine at Mount Sinai and co-Director of the Mount Sinai Kravis Children’s Heart Center, answers common questions that parents may have about diagnosing a pediatric heart condition and explains the safe, minimally invasive treatments that are now available.

How do I know if my child has a heart condition?

Many heart problems in children are obvious nearly from the moment of birth. In fact, the most common types of heart disease in children are congenital heart diseases, which are birth defects that affect how the structure of the heart as well as how the heart functions. Congenital heart disease is the most common birth defect, affecting a little less than one percent of the population.

One of the most common signs of heart disease among newborns is cyanosis, which is when a child has a low oxygen level, which lends a bluish tint to the skin and mucous membranes. Additionally, some newborns have symptoms such as poor feeding or sweating as they feed. Heart problems can also cause poor growth.

Still other concerns—like heart murmurs—are identified only through a physical examination or sonogram. Heart murmurs can be signs of a problem, or they can be what we call “innocent,” which means there’s actually nothing wrong. Some studies suggest that if a doctor listens closely enough, nearly half of all kids have murmurs. Fortunately, though, only a very tiny fraction of this group actually has a heart problem.

How are congenital heart diseases diagnosed and treated?

Most congenital heart conditions are diagnosed either on physical examination or ultrasound and increasingly can be diagnosed prenatally on ultrasound.

Depending on the diagnosis, there are a variety of surgical and non-surgical treatments for congenital heart disease. Non-surgical treatment or the “wait and see approach,” may be the best option for problems such as small holes in the heart and some forms of abnormal heart rhythm which can resolve spontaneously. If your child has a condition that needs surgical intervention, options range from open heart surgery to the use of catheter-based therapies.

What are catheter-based therapies?

Catheter-based treatment is a minimally invasive alternative to traditional open heart surgery in which small tubes are inserted into the blood vessels and allow for diagnosis and treatment of many heart problems. Among many conditions that can be addressed in this way, we use these procedures to close holes between the upper two heart chambers—called atrial septal defects. In the past, we routinely treated this condition with surgery. Now we manage about 75 percent using catheter-based treatments.

During a catheter-based procedure the thin, flexible catheter is inserted through the child’s groin into a blood vessel and up to the heart. A device is then introduced through the catheter to seal the hole. With open heart surgery, the child would spend two to four days in the hospital and another six weeks recuperating at home. Using this minimally invasive approach, most patients are in the hospital only one evening and then back in school within three or four days.

What makes the Mount Sinai Children’s Heart Center special?

Our Children’s Heart Center stands apart due to the integration among our services throughout the expanded Mount Sinai Health System. Our cardiology team works closely with our surgical team, and we seamlessly transition our pediatric patients into our very large and always growing adult congenital heart program headed by Ali N. Zaidi, MD, Associate Professor of Medicine (Cardiology), and Pediatrics; Director of the Adult Congenital Heart Disease Center; and Director of Pediatrics to Adult Transition of Care Program, at Icahn Mount Sinai. We view our work as a team sport, with many players working together to achieve the best possible outcome.

We develop individualized treatment plans for children with a wide range of heart problems, always taking into account the needs of our patients and their families. While there are outstanding cardiologists in many of the major centers in New York City, I have never worked with a group where every single physician is outstanding. It is inspiring for me and keeps me on my toes. Our patients inspire us every day.

Learn more about the Mount Sinai Kravis Children’s Heart Center

How Is the Omicron Variant Affecting Children?

Updated on Jun 30, 2022 | Children's Health, COVID-19, Your Health

The Omicron variant is the latest strain of COVID-19 that is causing concern. While far more contagious than earlier variants, there are indications that it causes less serious disease—especially in the vaccinated.

Despite this sliver of good news, reports of increased pediatric hospital admissions has many parents and guardians worried that this variant may be more dangerous for children. Pediatric infectious disease specialist Roberto Posada, MD, Professor of Pediatrics and Medical Education, at the Icahn School of Medicine at Mount Sinai, dispels that belief and explains how to protect yourself and your family. The key takeaways: if eligible, get vaccinated; wear a high-quality face covering while indoors; and practice social distancing.

Is the Omicron variant more of a risk to infants and toddlers than older kids and adults? What are the symptoms?

The Omicron variant is very widespread and it affects people of all ages. That includes infants, toddlers, school-age kids, adolescents, and adults. It does not discriminate by age—everybody is at risk.

For the vast majority of children, symptoms of this variant are very similar to other common illness of childhood. This includes fever, a runny nose, cough, congestion, a sore throat, and/or difficulty swallowing. Some kids also complain about abdominal pain and diarrhea.

My child has COVID-19. How can I treat them at home?

Treatment depends on how ill your child is but the vast majority can be treated at home using over-the-counter medications. For instance, children who are experiencing minor symptoms, like fever and body aches, can be treated with acetaminophen (Tylenol) or ibuprofen.

However, if you think that your child is sicker than you can handle at home or if they are having difficulty breathing or eating so little that you are worried about dehydration, call your doctor right away.

How can we protect children from the Omicron variant?

Vaccination goes a long way toward protecting children—and adults—from the Omicron variant, and a booster shot provides additional defense against the virus. So, if you (or your child) are eligible for a booster but have not received one, I encourage you to schedule an appointment. By protecting yourself, you are protecting your child.

In addition to getting vaccinated, wearing a mask and maintaining social distance are very important. Since COVID-19 is circulating at very high levels, try to avoid crowded places. Also, make sure that your child understands the importance of washing their hands frequently, either with soap and water or an alcohol-based sanitizer.

If your child happens to feel sick, keep them home from school so that you can prevent an infection from spreading to others. If you think somebody in your family has COVID-19, reach out to your doctor about testing for the virus. If your child attends a daycare or school, you might need to alert them as other close contacts of your child may need to get tested. Be sure to follow whatever directives their daycare/school has outlined.

My child is not yet eligible for vaccination. How can I protect them from contracting COVID-19?

Unfortunately, the vaccine is not available yet for kids who are younger than 5 years of age. In that case, it’s even more important for parents, older siblings, and whoever else lives at home to be fully vaccinated and to get a booster shot. In addition, all household members should diligently follow the rules we have followed throughout this pandemic: avoid crowded places, wear a face covering, maintain social distance, and wash your hands frequently.

Why Vaccination Is Critical to Protect Your Child From COVID-19

Updated on Jun 30, 2022 | Children's Health, COVID-19, Your Health

As we see an uptick in pediatric hospitalizations for COVID-19, it is important to reemphasize the significance of vaccination.

“Most of the children that we’re seeing in the hospital with COVID-19 have not received a vaccine—or have only received one dose,” says Roberto Posada, MD, Professor of Pediatrics and Medical Education, at the Icahn School of Medicine at Mount Sinai.

In November 2021, the U.S. Centers for Disease Control and Prevention (CDC) endorsed COVID-19 vaccination for children ages five and up. But, if you have been hesitant to schedule an appointment for your child, Dr. Posada explains vaccine safety and why vaccinating—and, if eligible, boosting—your child is a critical step in avoiding COVID-19.

Should all children ages five and older get the COVID-19 vaccination? What if my child had, and recovered from, the virus?

Yes, the CDC recommends that everyone age five and up get vaccinated. The vaccines are very, very effective at both preventing serious disease caused by COVID-19 and keeping people out of the hospital if they do get the virus. The vaccine is extremely safe and has been tested in patients of all ages. Serious side effects are very, very rare.

Vaccination is recommended even if you have had COVID-19. This includes children who are eligible to receive all the doses of the vaccine, including the booster. Why? Because vaccination offers higher protection than previous infection.

Children ages 12 and older get the same dose as adults. Children ages 5 to 11 get a lower dose of the same vaccine. Currently, only the Pfizer vaccines have been approved for children ages 5 to 11.

Does the vaccine give children full protection against COVID-19?

Children who have been vaccinated for COVID-19 have a high level of protection against the disease; but it is not 100 percent. People who’ve gotten the vaccine are much less likely to get sick. But if they do contract the virus, it’s much less likely that they’re going to get severely sick from it.

Also, we are beginning to see the significance of booster doses of the COVID-19 vaccine. Research shows that protection starts to decrease a number of months after the second COVID-19 vaccine dose. A booster dose provides an added layer of defense against the virus, including protection against the Omicron variant.

Are children eligible for a COVID-19 booster dose?

Everyone over age 12 is eligible to receive the COVID-19 booster dose five months after their last shot. Since children over 12 have been eligible for the COVID-19 vaccine since May 2021, some may be ready for their booster dose. If they are, I highly encourage parents to book an appointment to administer the shot.

Children ages 5 to 11 are not yet eligible for boosters but they just became eligible for the COVID-19 vaccine in October 2021, so they would not need a booster at this point.

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