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 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...


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...


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: 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: 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 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....

Amniotic fluid problems

amniotic fluid smlThe 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. Amniotic fluid surrounds the foetus for the duration of pregnancy. This fluid not only cushions and protects the foetus but also plays a crucial role in the development of several foetal organs, including the lungs, kidneys and gastrointestinal tract. Amniotic fluid keeps the umbilical cord from being compressed against the uterine wall. The amount of amniotic fluid also reflects the baby’s urine output and provides an important, measure of foetal health.

Most women carry between 500 and 1000ml of amniotic fluid. Too much or too little amniotic fluid is linked to problems in foetal development and complications during pregnancy.


Too much amniotic fluid (polyhydramnios or hydramnios) is problematic because it stretches the uterus and puts pressure on the diaphragm of pregnant women. This can result in preterm labour (before 37 weeks gestation) or premature rupture of the amniotic membrane. When the amniotic sac bursts, excessive fluid leaves the uterus, increasing the risk of placental abruption (early detachment of the placenta) or umbilical cord prolapse (when the cord falls down through the cervical opening) where it may be compressed. Hydramnios is also associated with foetal birth defects. Excessive amniotic fluid can result in severe breathing problems for the mother.


Amniotic fluid may accumulate due to an overproduction of fluid, problems with the fluid being taken up, or both. Maternal or foetal factors potentially contributing to hydramnios include:

  • Diabetes in pregnant women
  • Multiple births (more than one foetus)
  • Rh incompatibility (occurring when a pregnant woman has Rh-negative blood and the foetus has Rh-positive blood)
  • Birth defects, resulting in a blocked oesophagus/abnormal swallowing due to problems with the central nervous system (such as spina bifida) or chromosomal abnormalities
  • Gastrointestinal abnormalities that block the passage of fluid
  • Twin-to-twin transfusion syndrome
  • Heart failure
  • Congenital infection (acquired in pregnancy)
  • Unknown factors


  • Abdominal discomfort
  • Bloating
  • Swelling in the legs
  • Rapid growth of the uterus
  • A larger uterine size (fundal height) than expected for gestational age
  • Uterine contractions
  • Breathing difficulties


The symptoms of hydramnios are similar to other medical conditions and pregnancy itself. Diagnosis is generally made on the basis of an ultrasound scan, together with a complete medical history and physical examination. An ultrasound is a test that uses sound waves to create a picture of internal structures and is able to measure pockets of fluid to estimate the total volume. This form of imaging may be helpful in ascertaining the cause of hydramnios, such as multiple pregnancy or birth defects. Hydramnios is also detected during a prenatal exam, when your fundal height (the distance from your pubic bone to the top of your uterus), measures outside the normal range.


The primary aim of treatment is to relieve the mother’s discomfort and safely continue with the pregnancy. Factors to consider include maternal health, medical history and personal preferences; extent and expected outcome of the condition, as well as maternal ability to handle specific medications, procedures or therapies.

Treatment options may involve close monitoring and frequent follow-up visits to oversee the amount of amniotic fluid. Your doctor may perform a procedure called amnioreduction-amniocentesis, to remove some of the excess amniotic fluid. The procedure involves inserting a needle into the uterus and amniotic sac. This process may need to be repeated. If the condition endangers the wellbeing of the mother or the foetus, early delivery may be required.

Hydramnios may cause preterm labour. Maternal bed rest and the use of steroids to enhance foetal lung maturity may be necessary. Excess amniotic fluid makes it easier for the foetus to flip and turn. This increases the risk of baby being in a breech (feet-down) position. Breech babies can sometimes be moved into the correct (head-down) position, but a caesarian may be required.


Oligohydramnios is a condition in which there is too little amniotic fluid surrounding the foetus. Oligohydramnios occurs in approximately 4% of all pregnancies. The condition is problematic because it may affect foetal development or cause complications during delivery. Insufficient amniotic fluid for long periods of time may result in abnormal or incomplete lung development (pulmonary hypoplasia). Poor foetal growth (intrauterine growth restriction) is also associated with decreased amounts of amniotic fluid. Oligohydramnios increases the risk for compression of the umbilical cord and aspiration of thick meconium (baby's first bowel movement).


  • Oligohydramnios is generally caused by conditions that affect or prevent the production of amniotic fluid including:
  • Twin-to-twin transfusion syndrome
  • Tear in the amniotic sac before labour
  • A problem with the placenta, such as placental abruption (the placenta either partially or fully peeling away from the uterine wall)
  • Post-term pregnancy
  • Birth defects, particularly malformations of the kidneys and urinary tract
  • Problems in the mother, such as dehydration, diabetes or high blood pressure
  • Complications of certain medications, such as angiotensin-converting enzyme (ACE) inhibitors


Oligohydramnios usually does not result in any symptoms. If the amniotic membrane ruptures prematurely, you may experience a gush of fluid from the vagina. The fluid may leak out slowly, resulting in constant wetness. Your health provider may notice that your abdomen is smaller than expected for your gestational age.


The condition is diagnosed by means of your symptoms (if present), medical history, a physical examination and relevant tests. Your doctor will perform an ultrasound to view the uterus and foetus for any signs of a problem and to measure the levels of amniotic fluid. Blood tests may be required, to detect health problems in the mother. Other tests may be ordered, if your doctor suspects a problem in foetal health.


Treatment generally involves close monitoring to ensure foetal health and detect any worsening of the condition. More frequent health visits and ultrasounds are necessary in this regard. You may be advised to drink more fluids, especially water. Your doctor may add fluid to the amniotic sac after you are in labour. This procedure (known as amniofusion) helps cushion the umbilical cord during contractions.


The only way to prevent oligohydramnios is to identify the underlying cause and treat it if possible. Discuss any medication, supplements or alternative treatments you are using before getting pregnant. A healthy diet, adequate rest and fluid intake, vitamin supplementation and regular exercise, all contribute to a healthy pregnancy. Schedule and attend regular check-ups throughout your pregnancy, and undergo the necessary screenings and blood tests.