Baby Clues
Information & advice on dealing with babies

Doctors at a clinic that failed to spot a broken back in Baby Peter two days before he died were under an “excessive workload”, a report has said. Peter Connelly, killed in 2007 in Haringey, north London, was seen at St Ann’s Hospital two days before he died. Dr Kim Holt, who warned about the way the clinic was run in 2006, said the 17-month-old baby could have been saved if managers had listened to her.

But the report found “genuine attempts” were made to address her concerns. Dr Kim Holt, a senior consultant paediatrician, had warned the clinic’s appointment system was “chaotic”. She was one of four who wrote a letter detailing problems at the hospital’s clinic a year before the failed diagnosis. They warned the clinic – run by Haringey Primary Care Trust and manned by Great Ormond Street Hospital doctors – was understaffed.

There had once been four doctors at the clinic, but two posts were cut before Baby Peter’s death. Since the case, the number has risen to nine. The independent report found “delays in seeing children must have the potential to affect patient safety”. It described Dr Holt as highly intelligent and committed, and added that communication between doctors and senior administrators needed to be managed “more effectively in the interests of patient care”.But it also said “genuine attempts” had been made to improve the situation after Dr Holt’s letter.

The report’s authors described the workload of consultants at the clinic between 2006 and May 2008 as “excessive” and said the consequences of cutting a consultant post “were not adequately considered” by management. They also noted complaints of a “very hostile environment” at the clinic with poor communication between staff and managers. But they concluded: “We do not consider, however, that this descended into a bullying regime.”

After the publication of the report, Dr Holt said said she and her colleagues’ concerns were about the “quality of care” given to children at the clinic. Tracey Connelly was jailed for her part in Baby Peter’s death
She said: “We followed internal Trust channels, only going outside when they had been exhausted.
“I hope now that everyone will be able to learn from this report and move on. “I also hope that in future it will be far easier for NHS staff, in Haringey or anywhere, to speak out in the interests of their patients, particularly those who have no voice of their own.” Professor Trish Morris-Thompson, chief nurse at NHS London, said: “We accept in full the findings of this independent report, and we are working with NHS Haringey to make sure recommendations are put in place.”This report shows that Dr Holt’s concerns were taken seriously.”

The British Medical Association (BMA) is supporting Dr Holt’s claim to be reinstated to her original post.
In a statement Great Ormond Street Hospital said: “The Trust welcomes the report, accepts its recommendations and now wants to move to try to resolve outstanding issues swiftly and amicably.”
It added: “The Trust has apologised for its mistakes in the care of Baby Peter and has acted on all recommendations made.

Baby Peter died from abuse despite 60 visits from the authorities. His mother Tracey Connelly, 28, her partner Steven Barker, 33, and Barker’s brother Jason Owen, 37, were all jailed for their part in Peter’s death.
Haringey Council’s social services department was heavily criticised following the killing.

This is just one instance of a clinic where a child died as a result of abuse injuries being ignored due to being short staffed. This is just one of many, indicators that the NHS needs to be reviewed

Cradle cap is the name given to the yellowish, greasy scaly patches that appear on the scalp of young babies. It is a very common, harmless condition that does not usually itch or cause any discomfort.It usually begins in babies during the first three months and tends to last a few weeks or months. It normally clears up by the time the child is two years old, although in rare cases children can have cradle cap for a lot longer. The exact cause of cradle cap in unclear, although it is thought that it could be caused by overactive sebaceous glands.

Symptoms of cradle cap include:

• greasy yellow patches on the scalp,
• the affected skin area appearing red
• scales and flakes on the scalp,
• yellow crusts on the scalp.

There is a possibility that the child will have hair loss when the patch falls off or is removed. It is important not to scratch or pick at the cradle cap, in case an infection develops. It usually starts on the scalp and can spread behind the ears. The patches may appear on other parts of the baby’s body, such as the nappy area (groin), the nose, armpits or backs of the knees. In this case, the condition is called seborrhoeic eczema (dermatitis), rather than cradle cap.

Cradle cap normally requires no specific treatment, although gently washing the baby’s hair and scalp may prevent a build-up of the scale. To help to loosen the crust, massage a small amount of olive oil into the scalp at night. This will help to soften the patchy scales. In the morning, using a soft baby brush or cloth, gently remove any loose particles, and then wash the hair with a baby shampoo.

If this does not work then try a mild shampoo but be careful with baby’s eyes as these shampoos are stronger than baby shampoo. If the cradle cap becomes inflamed or infected, a course of antibiotics or an antifungal cream or shampoo, such as ketoconazole, may be prescribed by a doctor. A mild steroid cream such as hydrocortisone may be recommended for an inflamed rash.

If the cradle cap does not improve with treatment, or the baby has seborrhoeic dermatitis on the face or body, speak to your health visitor or GP for advice

We all know that when you have kids you cant take your eyes off them; sometimes when you do funny things happen as demonstrated in the article don’t take your eyes off them but sometimes tragedy occurs. One of the most recent examples of this was 18 month toddler Brad Kremer who fell from a first floor balcony whilst on holiday in Sardinia. His parents had gone to get changed when he wandered onto the balcony and fell to his death. Another is that of Madeline McCann who was abducted in 2007

So here a few tips to keep your little one safe because we all know that it is impossible to watch them every second:

• If you are in a flat or apartment ensure that there is no way that the toddler can get onto the balcony without supervision, whether you put your child in a playpen, put them in a different room or lock the door is up to you
• Never leave your child alone near water
• If you go on holiday NEVER leave your child unattended
• At the beach set clear boundaries as to where your child can go
• When out and about always arrange a rendezvous point where everyone is to go to if seperated

Whilst it is important to be aware of the potential hazards there is no need to wrap your child in cotton wool otherwise your child will be permanently living in fear.

The chemical DEET which is found in many insect repellent sprays has been shown to be toxic and can cause fits in children, the current advice is that it should not be used by pregnant women. In research studies DEET blocked the enzyme cholinesterase, which is essential for sending messages between the muscles and the brain which can cause muscle spasms and in severe cases death. Other side effects of DEET are excessive salivation and eye watering.

DEET, is also known as diethyl toluamide, and is used in a many repellent sprays. Initially it was thought that the DEET simply altered the insects sense of smell to prevent them from detected the smell of the human. However on further study it was found that it acts on the enzyme which is present in both insects and mammals. Therefore the idea that it simply modifies insect behaviour is false as it directly inhibits enzyme activity in both mammal and insect nerves, research also shows that DEET interacts and strengthens the toxicity of carbamates, a class of insecticides also known to block acetylcholinesterase.

This research raises questions with regards to the safety of insect repellents, however at present it is mainly based on theory and tests on animals if you are at all concerned speak to a pharmacist or a doctor. Alternatively try alternatives from your health food shop

Parents are always ecstatic when their child is the first to do something before their peers whether it is potty training or learning to walk. So you can imagine the joy when Georgina became the youngest member of Mensa! She has an IQ of 152 which puts her in the same category as Professor Stephen Hawking.

Due to her age Professor Freeman, a specialist educational psychologist applied standard Stamford-Binet Intelligence Scale test but was amazed to find that this test was too limited for her creative abilities.
Here is a list of some of the things she can do:

• Do Ballet
• Can differentiate between a square and a rectangle
• Draw an almost perfect circle
• Use words such “arrogant” correctly in conversation
• Explain complicated words to her friends
• Can distinguish between pink and purple

If you think that’s impressive she was walking by the time she 9 months, and was able to dress herself and put her shoes on the right feet by the time she was 14 months. In Mensa there are only 30 under the age of 10. With an IQ of 152 she is in the top 0.2% of the population as a result her parents are worried about her education as she is well above the ability of her peers.

This child was raised as any normal 2 year old with 4 older siblings. So it just goes to show that you shouldn’t underestimate your child they are brighter than you think.

Private schools, also known as independent schools are funded in whole or in part by charging their students tuition, instead of being funded by the public (state). Schools claim that the high tuition fees pay higher salaries for the best teachers and also used to provide enriched learning environments, including a low student to teacher ratio, small class sizes and services, such as libraries, science laboratories and computers. Some private schools are boarding schools and many military academies are privately owned or operated as well.

Special assistance schools aim to improve the lives of their students by providing services tailored to very specific needs of individual students. Such schools include tutoring schools and schools to assist the learning of handicapped children.

This week the Charity Commission issued reports on the first batch of test cases since the law was changed to require private schools to show they are bringing “real benefit to the public”. For the schools that failed the test this is serious. They will have to address quickly what they must do to hold onto the significant tax advantages of charitable status. If they lose the charitable status they may have to increase their fees thus alienating the middle class.

It would seem that private school is the way to go but they exclude a large percentage of the population, which can limit your child’s interaction a broad spectrum of people. However it has its advantages

• Smaller classes
• Latest text books
• Up to date technology
• Better facilities

The number of NHS trusts who claim that they are following the child protection guidelines has declined. According to the Care Quality Commission (CQC) there has been a 3.1% decline in reporting compliance, but the vast majority of those were meeting these and many other standards. The Care Quality Commission (CQC) found a 3.1% decline in those reporting compliance, but the vast majority were meeting these and many other standards. Half of all trusts report that they are meeting all measures concerning issues ranging from hygiene to patient confidentiality. In the period 2005-2006 only 1 in 3 trusts were meeting the the measures.

The child protection guidance includes making sure staff are trained in recognising children who may be at risk, those who fail to meet these standards could lose their licence.

Those who defend the NHS argue that “The NHS has delivered steady improvements in compliance and that should be commended. But it remains concerning that all trusts aren’t meeting core standards on safety and quality, five years after they were introduced. They also argue that anyone reading all of the report cannot fail to come to the conclusion that there is a great deal that is improving in the NHS. However there is still considerable room for improvement and the service recognises that.”

There has been a greater focus in recent years on the areas of child protection and employment checks. Statistics show that standards in these areas are not improving but it should be emphasised that in these cases trusts are both being expected to deliver more and are asking more of themselves.

Baby massage is as the name suggests a massage for babies. There are numerous benefits to using baby massage these include:

• Relieving colic – for the lucky few who don’t know what colic is see colic – every parent’s nightmare in this case the benefits include relaxing the child and it can also dislodge the trapped wind.
• Acting as a bonding aid – the reason for this is it is an activity that enables one to one interaction between you and your baby. It can also build trust as your baby learns that touching in certain situations is OK (obviously I am not saying that touching as part of sexual abuse is OK) and they learn that you are not going to hurt them.
• Can help with constipation – this is because the strokes used on the abdomen are clockwise (which is the direction the gut moves) which can aid peristalsis (contractions of the gut – which move the faeces along the digestive tract).

If you want to try baby massage:

• Find a time of day when your child isn’t tired, hungry etc.
• Get a towel and an oil ready – you can use baby oil or any oil that you would use for cooking I personally use olive oil.
• In a room which isn’t too hot or too cold remove the child’s clothes, it’s up to you whether you leave the nappy on or take it off
• Lie the child on the towel then add a small amount (approx 1 tsp) of oil to your hand then rub your hands together – the purpose of the oil is to reduce the friction.
• Depending on the reason you are using baby massage will depend which of the following techniques you use:

For Colic

• If your child is lying on their back – starting just below the rib cage move your hand in large clockwise circles over the abdomen – repeat as desired
• Then starting at the belly button use 2 fingers and move in clockwise circles working out -repeat as desired
• Then start at the base of the rib cage move your hand across the chest to the opposite shoulder then repeat to the other side – repeat as desired
• If the child is lying on their front start at the base of the rib cage move your hand across the back to the opposite shoulder then repeat to the other side – repeat as desired

For Constipation

• If your child is lying on their back – starting just below the rib cage move your hand in large clockwise circles over the abdomen – repeat as desired
• Then starting at the belly button use 2 fingers and move in clockwise circles working out -repeat as desired

For a general massage

• If your child is lying on their back – starting just below the rib cage move your hand in large clockwise circles over the abdomen – repeat as desired
• Then starting at the belly button use 2 fingers and move in clockwise circles working out -repeat as desired
• Then start at the base of the rib cage move your hand across the chest to the opposite shoulder then repeat to the other side – repeat as desired
• If the child is lying on their front start at the base of the rib cage move your hand across the back to the opposite shoulder then repeat to the other side – repeat as desired
• To massage the arms cup your child’s upper arm just below the shoulder gently move your hand around the arm continue down the arm until you reach the wrist. It works best if do both arms at the same time.
• To massage the legs repeat the same technique as the arms starting from the hip down to the ankles

If at any point during a massage your child is showing signs of not enjoying it STOP. If you attempt to continue your child will associate the discomfort with the massage which is something you want to avoid. From personal experience with baby massage I have found that it is best to be consistent so for each body part use the same number of strokes I usually work in groups of 5. Also it may be of interest to you that you don’t have to stop massages when your child becomes a toddler my daughter is now nearly 2 and still enjoys having a massage, I started from when my daughter was 6 weeks old but there is no reason why you can’t start from birth.

Originally a Nursery was typically a private establishment that provided daycare for children from birth through to school age and a playgroup provided preschool education and prepared a child for school, however in an attempt to get playgroups to take themselves and the educational element more seriously they are now referred to as preschools by official bodies such as OFSTED.

However now the terms Nursery and preschool are now used interchangeably for example most infant schools have a Nursery attached to them which is targeted at children aged 3. The only thing I can suggest is ignore the name and treat each daycare provider as individual and decide which is the right place for your child.

At the moment I am in the process of looking at putting my daughter into daycare to encourage her to mix with other children and learn the social skills associated with mixing with her peers such as sharing and taking turns. So to find the right childcare provider here is an easy to follow list which you may find helpful:

• Make a list of all the daycare facilities in your area
• Cross off any that obviously don’t meet your criteria (wrong age, too far etc)
• Call the remaining providers and ask them to send you an information pack (obviously for some small providers they may not be able to offer an information pack but they can give you any information you ask
• Based on the information you are given choose your top 3 and arrange to have a look around
• Once you have visited the providers decide which one you liked the best and enrol your child
• Take your child for a few sessions to get them settled in before they officially start

Once you have found the right place to send your child ensure that you explain what is happening to your child otherwise it can cause your child to feel abandoned and can make it difficult for your child to settle, as it is a strange experience being away from their parents with people they don’t know very well. It can also cause behavioural problems as they may not be able to verbally express how they are feeling so may express it through bad behaviour, so the key is maintaining good communication with your child and making sure that you find time to spend 1 to 1 with them so that they know that you still love them and that they can talk to if something is wrong.