Shaken Baby Syndrome

A large number of child deaths are reported in South Africa each year. A lot of deaths relate to neglect, abuse or murder. Despite this, there's a knowledge gap in relation to understanding the issue....

Amniotic fluid problems

The importance of amniotic fluid Amniotic fluid is essential for pregnancy and foetal development. Amniotic fluid is a watery substances residing inside a casing called the amniotic membrane or sac. ...

Choosing a pre-school

Becoming a parent is a momentous; life-changing event filled with hopes, expectations and naturally some fears. Parents often learn and grow alongside their children, as they face the challenges of pa...

Newborn reflexes

Although newborn babies are physically helpless and vulnerable at birth, they have a number of amazing innate abilities or reflexes. Reflexes are involuntary movements or actions, designed to protect ...

Mastitis

Mastitis is an inflammation of the breast that can lead to infection. The word “mastitis” is derived from the Greek word “mastos” meaning “breasts”, while the suffix “-itis” denotes “inflammation”. Ma...

Pelvic floor exercises

Although your new baby will probably bring you immense emotional satisfaction, physically you may feel uncomfortable and strange in your own skin. After 9 months of pregnancy and hormonal changes, you...

Colic

Babies cry because they need to communicate something and most parents, especially new moms, find it distressing to see or hear an unhappy baby. In time, you will learn to recognize the various causes...

Antenatal Classes

Antenatal classes are informative sessions provided to prepare expecting parents for the birth of their child and the early days of being a parent.Most antenatal classes are run by Midwives and occasi...

Strap-in-the-Future

The Decade of Action for Road Safety 2011-2020 was launched on the 11 May 2011. It is a global declaration of war against road crashes and fatalities. According to Mr Sibusiso Ndebele, MP Minister of ...

  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52

Why babies cry and how to soothe them

Babies cry as a means of communication, to indicate that they are hungry, tired, scared, in pain, and more. Even entirely healthy newborns will cry for between 1 to 3 hours per day, because they are reliant on other people to meet their basic needs. ....

Toddler Sleep

Do toddlers really need naps? Yes. Naps are essential for your toddler's good health until the age of 4 years. Research suggests that naps are crucial to a baby's brain development. Without them, a child's physical and mental development can suffer. ....

Toddler eating

Is it normal for my toddler to eat less than she did when she was an infant? Because growth slows after the first birthday, it is normal for a toddler's appetite to decrease. Why does her appetite vary so much day to day? Because toddlers are eager ....

Will I hurt my baby’s soft spot if I rub it when I wash his hair?

The medical name for a baby’s soft spot is called the anterior fontanelle. This is an opening in the bones of the skull that allows the cranium to grow. The fontanelle is covered with a very tough membrane so you will not hurt it when washing or br....

What’s the best way to clean the whitish material that builds up between a baby girl’s outside and inside vaginal lips?

Cleaning the discharge that accumulates between the labia majora (outside vaginal lips) and labia minora (inside vaginal lips) bother parents as much as cleaning a little boy’s testicles. A girl is often born with this discharge and it protects the....

I’m worried that I will hurt my son’s testicles when I clean him up after a poo.

Before puberty, it does not hurt if a boy’s testicles are manipulated. Although it’s logical to be gentle, don’t worry about causing your son any pain when you clean him up after a bowel movement.

When I’m changing my baby, I notice tiny opalescent beads around her anus and vagina. If I rub them between my fingers, they have a slight waxy feel. What is this?

It’s called an Epstein’s Pearl and is nothing to worry about. The pearl is composed of mucus cells trapped under a thin membrane. It will go away in the first few weeks of life. Babies often have two variations of this lesion that you may see in ....

Why does my baby get hiccups after she feeds?

Breastfed and bottle fed babies can often get hiccups after feeding. This happens because they reflux some stomach contents into their oesophagus after eating and the acid stimulates a nerve that causes the hiccups. Hiccups generally resolve after a ....

Although my baby takes her bottle without any problems, she spits her pacifier out. Why doesn’t she like it?

Babies don’t suck on things the way we do. Instead of creating negative pressure with their cheeks (that’s what kids and adults do), they lick with their tongues at the same time they work their jaws. Therefore, when a baby sucks on a pacifier, s....

When will I be able to tell the colour of my baby’s eyes?

Babies of European descent usually have dark, slate blue eyes at birth. Babies of Asian or African descent usually have brown eyes at birth. Final eye colour is usually apparent by six months of age, but occasionally remains a mystery until a baby is....

The whites of my baby’s eyes are blue. Is that normal?

The white part of the eye is called the sclera and the tissue inside the sclera is called the choroid. The choroid is bluish in colour and it can be seen through the sclera in the first few months of life because the sclera is thin. If an older baby ....

Can I take my baby out?

Of course. Going out for a walk is a great activity. If the baby is in a pram, protect them from direct sunlight and dress them warmly enough. If carrying them in a pouch, protect their head and face from the sun or wind. Take care not to overdress t....

Is it safe to leave my baby alone?

As long as the baby is in his cot, you can hear your child if he cries (get a monitor if necessary), the room is a comfortable temperature and he isn’t too hot then you can leave your baby to sleep alone. Do not leave a baby unattended on a couch, ....

How can I tell if my baby’s bowel movements normal?

When your baby is born his first bowel movements will be dark green or black and sticky, this is called meconium. They will then change to a mustardy yellow colour with small bits, often described as bird-seed like. A formula fed baby will have soft ....

Is my baby too hot?

Overheating is a recognized sign of Cot Death or Sudden Infant Death Syndrome (SIDS). To avoid overheating, place the back of your hand on the tummy or the neck, if it is damp or sweaty then your child is too hot, and you need to cool the baby down b....

Why does my baby cry all the time?

Crying is your baby’s only means of communicating. As you get to know your baby, so too will you get to know variances in his cries. He may just want attention or be lonely. He may also be uncomfortable, have a wind, be hungry, feel cold or hot. A ....

Is my child gaining enough weight?

Average, weekly weight gain is 200gms. Some babies only gain 100gms, some as much as 300gms. One week there might be a gain of about a 150 gm and the next will be about a 250gm weight gain. Bottle fed babies tend to start gaining weight from birth, w....

Can I really keep expressed breast milk in the freezer for 3 months?

Yes. Expressed breast milk can stay in the fridge for a maximum of 24hrs and in a good quality freezer for a maximum of 3 months. Frozen breast milk can be defrosted in the fridge or at room temperature. It should be warmed up to body temperature in ....

Do I need to clean my baby’s nose?

It is only necessary to clean baby’s nose if there is some congestion that may be interfering with feeding or sleeping. Saline nasal spray or drops are often sufficient to “wash” the congestion away. If it is thick nasal mucous, an aspirator ma....

Why must my baby face backwards in the car seat?

A baby should face backwards in their car seat for the first 9 months or until they weigh 9 kg. For the first 9 months, their head is approximately 1/3 of their body weight and if there is an impact it could cause a forward facing baby to be propelle....

My baby has crusty eyes in the morning, what can I do?

Newborn babies can get excessive “sleep” in the corners of their eyes due to an immaturity of the tear ducts. This can easily be wiped with moist cotton wool and it resolves itself by about 2 months. There can be an excessive amount of discharge,....

My baby just cries all the time, what can I do?

This depends very much on the circumstances behind the crying. (Read more: crying) or send me an e-mail: Elizabeth@tum2mom.co.za for a personal answer.

Do I need to give my baby water to drink?

Most babies under 5 months, drinking either breastmilk or formula do not require extra water to drink. One usually starts introducing cool, boiled water when introducing solid foods.

Can I travel with my little baby?

This depends on where, how and how long the journey will take. Send me an e-mail: Elizabeth@tum2mom.co.za for a specific answer.

Is it Ok for my baby to suck his thumb?

Yes. A lot of babies need to soothe themselves by sucking on their fists, which can become thumb-sucking as they get older. It is your choice if you wish to encourage this or the use of a dummy.

Can I feed my baby both breastmilk and formula?

This can be done and in various ways, however expressed breast milk and formula should not be mixed in the same bottle. Seek guidance from your clinic nurse or send an e-mail to Elizabeth@tum2mom.co.za for specific advice.

What is the difference between a posset and a vomit?

Bringing up a small amount of milk when a baby burps is called a posset. This is quite common, especially with breast fed babies. If the baby is healthy and gaining weight, there is no reason for concern. Larger amounts would be considered to be vomi....

When will my baby sleep through the night?

This is a difficult question to answer as there are many variables to the concept of “sleeping through”. Some parents see having 12 hours uninterrupted sleep as the goal, others only expect 8 hours uninterrupted sleep as ideal. Most understand it....

Can I use soap on my baby’s skin when I wash her?

It is advisable to use a very mild soap or aqueous cream when bathing baby for the first few weeks. Avoid soap on their face. If there is a reaction to any product that is used, seek medical advice to find a cleanser that is best for your baby’s sk....

My 3-month-old is drooling a lot and chewing on things. Does that mean she’s teething?

A few interesting things happen at three months of age: (1) a baby has enough motor skills to confidently grab objects and pull them to her mouth, (2) a baby likes chewing on things more than before, and (3) a baby’s major salivary gland (the parot....

My 6-week-old has a soft bowel movement twice a day. However, before she goes, she strains real hard and gets red in the face. What should I do to treat her constipation?

If your baby is feeding well and gaining weight, I don’t think she is actually constipated—the definition of constipation is producing hard, dry stools. Babies sometimes grunt and strain when having a bowel movement because of a reflex that tells....

My 2-month-old is losing her hair. When will it grow back?

It’s common for babies to lose their hair in the first few months of life. For some infants, the hair grows back quickly. For others, they may look like little old men until they are 9- to 12-months of age.

My 2-month-old baby hasn’t made a poo all week?

It depends on what baby is drinking. A baby drinking purely breastmilk can occasionally have no bowel movement due to growth spurts and as their digestive system matures. If there are plenty of wet nappies and the baby is comfortable give it another ....

What is the rash my 6 week baby has all over its face?

This is quite possibly millia, small tiny white spots usually spreading across the nose and cheeks and up onto the forehead and in severe cases over the whole face and into the neck. They can appear worse if the baby has very fair skin or is too warm....

My 3 week old is stuffy all the time and sneezes a lot. Isn’t he too young to have a cold?

Although your 3 week old is not too young to have a cold, the chances are he doesn’t. Babies have to breathe through their noses for the first few months of life. Their nasal passages are small, however, which explains the “stuffy” sound you he....

My son was circumcised three days ago. His penis was red at first, but now there’s some yellow pus on the head. What should we do?

Right after a newborn is circumcised; the head of the penis is bright red and has a “wet” look. Over the next few days, the head becomes drier and takes on a dull red appearance. The head returns to its normal skin colour about a week after the c....

My 3-week-old’s big toenails are in-grown. Is this normal?

Although this is a common observation, it is not usually due to truly ingrown nails. A newborn’s toenails have the consistency of parchment and because of intrauterine positioning; the nail may grow up against the fleshy part of the toe. The reason....

My 2-week-old has a small amount of milk coming from his nipples. Is this normal?

Male and female infants can be born with swollen breasts, due to the effect of maternal hormones on their breast tissue. A small percentage of babies also get a milky discharge from their nipples which resolves in a few days. You should not squeeze t....

My 10-day-old still has his umbilical cord. It’s gooey and smells bad. What should I do?

It is not unusual for the cord area to have an unpleasant smell a few days before it falls off. The reason for this is because the cord remnant is actually decaying, i.e., the umbilical stump does not have a blood supply and the body’s immune syste....

If I carry my newborn in a carry pouch, will it hurt his back?

Infants are very flexible and carrying them in an infant carrier will not cause back pain. The main thing to be concerned about when you use an infant carrier is that their head is well supported and that they don’t get too hot.

My newborn has overlapping toes. Should I tape them to straighten them out?

Things are pretty tight in the uterus and babies have a few “problems” because of this. Their shins are bowed because their legs were crossed in-utero, and their toes may overlap as well. If your newborn has overlapping toes because of these intr....

For the first week of my son’s life, I kept finding a pink stain in his nappy. Does he have blood in his urine?

Your baby was excreting uric acid crystals in his urine. This is a common finding in the first week or two of life. Although parents often report seeing “blood” in their baby’s urine, on further questioning we find out that there is a pink or s....

This morning I saw some blood coming from my 5-day-old’s vagina. Should I worry?

Baby girls commonly have a small amount of whitish discharge from their vagina. In some cases, this discharge turns bright red—it happens because the baby is shedding the lining of her uterus just like women do when they have their periods. This is....

My 1-week-old is peeling and has very dry skin around his wrists and ankles. What should I do about this?

During the pregnancy, babies are floating in amniotic fluid. For most of this time, they are covered with a greasy white material called vernix caseosa. Unfortunately, by the end of the pregnancy, the concentration of vernix lessens and the baby’s ....

My 3-day-old has a blister on her upper lip. Do you know where this came from and when it will go away?

This is called a sucking blister. It doesn’t bother the baby and usually falls off in a few days. Often a baby will get more than one in the first few weeks of life.

Is it normal to have piles after giving birth?

One third of women can develop piles during pregnancy. They are swollen veins around the rectum that may itch and ache or cause extreme discomfort. Ice packs can be applied to reduce the swelling as well as specific topical haemorrhoid ointments. Ple....

Why am I still bleeding a month after the birth?

Vaginal bleeding after the birth of your baby is from the uterus at the area where the placenta was attached. It can take up to six weeks for the uterus to return to its normal size and for the bleeding to stop. The blood should be dark in colour and....

Colic

ColicBabies cry because they need to communicate something and most parents, especially new moms, find it distressing to see or hear an unhappy baby. In time, you will learn to recognize the various causes of your baby’s cries such as thirst, hunger, and the need for comfort, sleep or temperature regulation. Between 3 and 14 weeks, some otherwise healthy, well-fed babies develop habitual periods of prolonged, significant distress known as colic. These crying spells generally occur in the evening, although they can happen at anytime of day. Babies with colic often cry more than 3 hours a day, 3 days a week, for 3 weeks or longer.

No one knows exactly what colic is or what causes it but many doctors believe that it is a type of stomachache. Colicky babies go red in the face and draw up their legs in pain. The baby appears miserable and distressed, and then calms down for a few minutes before starting to scream again. This type of crying would indicate cramp-like pains. Colic usually doesn’t respond to soothing techniques that work at other times. Persistent crying can become wearing and upsetting for both you and your baby. Luckily, colic usually stops as abruptly as it starts, having caused your baby no harm. The fact that your baby is content during the day means that this type of crying is not related to a serious physical problem. Colicky babies are generally otherwise healthy and thriving.

Causes

The cause of colic is unknown. Various theories have been proposed. It has been suggested that colic is related to trapped wind, constipation or indigestion. Some wonder if baby’s immature gut is sensitive to substances in breast or formula milk. Allergies and lactose intolerance have been considered. Links have been drawn between the end of the day, as a busy, stressful time and baby being sensitive to, and reacting to the tension. There is no evidence to support any particular causative factor.

Symptoms

Babies with colic:

  • Cry for seemingly no apparent reason
  • Cry in the evening or at the same time of day
  • Make sounds that are more intense in pitch or sound than normal
  • Appear perfectly well and healthy when not in tears
  • Refuse to settle and cannot be soothed
  • Sometimes wake from a short sleep with a startled cry
  • Sometimes take a long time to eat, fuss through a feeding, or want to nurse constantly

Other signs may include:

  • Arching of the back
  • A red, flushed face when crying
  • Clenched fists
  • Tightening of the stomach muscles
  • Abdominal bloating
  • Pulling the arms and/or legs towards the belly area
  • Passing gas while crying due to swallowed air

Risk factors

Colic is a common condition, affecting between 10 and 30% of infants. Colic is equally prevalent in boys and girls, occurring in both breast and bottle-fed infants. Colic is most common in babies of 2 weeks to 4 months old. It tends to occur more frequently in babies with a sensitive temperament and those whose mothers smoked during pregnancy or after birth.

Diagnosis

Traditionally babies were diagnosed with colic if they displayed sudden, unexplained outbursts of crying in accordance with the “rule of threes”: crying at least 3 hours a day (most commonly in the late afternoon or evening), for 3 days a week, beginning within the first 3 months of life. Some colic experts recommend that any intense, protracted crying that affects baby’s development or the parent-child relationship is worth treating.

Documenting the situation may provide your doctor with a more accurate picture and clues as to why your baby may be crying and what can be done about it. Keeping a colic diary may be helpful. Include as much information as possible, such as:

  • Do the crying bouts occur at the same time each day? How frequently? How long do they last?
  • Are they getting better or worse?
  • How often does your baby spit up? How long after a feeding and with how much force?
  • If you are breastfeeding, have you noticed a link between what you eat and how much your baby fusses?
  • If you are bottle-feeding, does there appear to be a connection between the crying and the type of formula, bottle, or nipple you use?
  • Does your baby gulp air or pass a lot of gas?
  • How frequently does your baby have a bowel movement? Is the stool soft or hard?
  • Which soothing strategies have you tried? Have any of them been helpful?

Differential diagnosis

Your doctor will take a detailed medical history and perform a physical examination. Your baby’s weight and weight gain are important considerations. Normal weight gain is typical in infants with colic. If your baby is failing to thrive, displays atypical symptoms or there are any doubts about diagnosis, alternative possibilities may be considered. Gasto-oesophageal reflux disease (GERD) is the most common differential diagnosis. The possibility of allergies to certain foods, formula or lactose intolerance may be explored. Your health provider will consider other conditions that may cause inconsolable crying, such as ear infection, hernia or blockages of the intestinal tract. Your baby’s sleep cycle and processing of environmental stimuli may provide useful information.

Treatment

There is no reliable treatment for colic, requiring a trial and error approach. The condition usually resolves on its own without medical or drug intervention. However, the symptoms of colic can be very upsetting and stressful to manage. Self-care is crucial to get through this difficult time. Enlist support of family and friends, get as much rest as possible while your baby is sleeping and take time out if necessary.

Have an in-depth discussion with your physician before trying any complimentary or alternative treatments. Some natural products can trigger allergic reactions or have unwanted side effects.

Feeding tips

Overfeeding can cause gas and discomfort. Feed your baby small amounts of breastmilk or formula every 2-3 hours. A baby’s stomach is the size of a fist. Smaller volumes of food are easier to tolerate, leave the stomach faster, and generally result in less spitting up. Try a nipple with a smaller hole to slow down feeds.

Burp your baby during and after feeds to release trapped gas. To do this, sit your baby upright or hold them against your shoulder. Ensure that their head and neck are carefully supported. Gently rub their back and tummy until they burp.

To reduce the amount of air your baby swallows, feed them in an upright position. Aim to keep your baby upright and quiet for half an hour after feeding, as it lessens the possibility of food flowing back into the oesophagus.

Breastfeeding moms are advised to limit their caffeine intake. Alcohol and spicy foods can also aggravate colic. If a specific or allergenic food is identified as a potential trigger, you may be advised to remove the substance from your diet for a week to see if it makes a difference. Common culprits include diary, peanuts, eggs, tree nuts, wheat, soya, fish and calciferous vegetables, such as broccoli and cauliflower. Any long-term dietary changes require medical supervision and possible supplementation.

Your doctor may recommend a change in formula, such as whey protein, soy protein, reduced lactose or hypoallergenic brands.

Soothing and calming tips

Babies often respond to motion. Place your baby in a sling carrier on the front of your body and walk around. The combination of warmth and rhythm may lull him to sleep. Similarly, sit your baby in a rocking chair, swing or pram. The gentle movement may have a soothing effect. If all else fails, many parents find that a drive in the car gives them a reprieve.

Hold your baby in different positions, such as on your shoulder, cradled in your arms, or lying tummy down along your forearm or lap. Try skin-to-skin contact.

Many babies also respond well to white noise. The monotonous humming of a fan, vacuum, or clothes dryer may have a soothing effect.

Colicky babies tend to be sensitive to stimulation and may become overwhelmed by bright lights and loud sounds. Place your baby in a quiet, dark room and swaddle them in a comfy blanket. Alternatively, lay baby across your lap and gently rub their back.

Time out

If you are feeling desperate and exhausted, accept help from friends or family. Alternatively hire a sitter and take some “me time”, outside the home. Do something that you enjoy to give yourself a sense of normality, such as going for a walk or having a coffee. A break from your baby, will allow you to regroup, have some quiet time and gain a sense of perspective. When there is no one around to help, it is ok to briefly leave your baby in their crib, while you calm and contain yourself in another room.

No matter how desperate you feel, never hit or shake your baby. If you think about or feel like hurting your baby, contact your doctor immediately and ask for help. A colicky baby can wear down even the most patient and resilient parents. It is common for parents to feel depressed, angry or helpless. It is ok to say you are not ok and ask for support and advice. It may be useful to talk to parents of other colicky babies. Reassurance that you are not alone and that colic attacks do pass, may make them easier to bear.

Prognosis

The prognosis for colic is excellent. Most babies recover spontaneously within 3-4 months.

Consult your doctor immediately if your baby:

  • Has diarrhoea, especially with blood in it
  • Has a fever
  • Vomits
  • Refuses to eat and doesn’t gain weight
  • May be sick or injured
  • Seems more lethargic and sleepier than normal

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