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

Health and Safety

Jaundice: signs and treatment

More than half of all newborns develop jaundice, a medical term describing a yellowish skin coloration. The yellow colour is caused by an excess of bilirubin, a chemical produced during the normal breakdown and replacement of red blood cells. In older children and adults, bilirubin is automatically eliminated from the body very quickly. But a baby’s immature liver sometimes isn’t able to process all of it, and its build-up causes jaundice. Bilirubin levels can rise due to a number of factors: immature functioning of the liver, baby has an infection, bruising of the baby’s scalp from an assisted delivery, obstruction of the bile ducts, or blood type incompatibility.

 

To check for jaundice, hold your baby in natural light and:

  • Press your fingertip gently against your baby’s forehead or the tip of his nose. The skin should look white (for babies of all races). If it looks yellowish, report it to your physician.
  • Check the whites of your baby’s eyes. If they look yellow, call your doctor.

Jaundice is usually harmless and clears up after a few days, but your doctor will take regular blood tests to keep close tabs on it because extreme cases can cause brain damage. If your child’s condition does not improve, your doctor may recommend phototherapy. This common treatment – in which the baby is placed under ultraviolet lights in the hospital – will clear up jaundice in a day or two. You can also ask your paediatrician about renting a portable phototherapy machine that you can use at home.

Very mild jaundice can be treated by placing baby in a sunny place. Undress baby, leaving nappy on, and place in a warm, draught-free, sunny room. Care for baby in that room while the sun is shining, i.e. feeding, sleeping etc to expose baby to as much sunlight as possible. DO NOT place baby in direct sunlight as she will sunburn very quickly.

 

Anecdote

My paediatrician told me that Chloe had slight jaundice at birth, but nothing to be too concerned about. She was not a very good feeder and did not want to breastfeed for long periods. My lactation consultant was concerned that her jaundice was making her feel too tired to breastfeed. I went to the Park Lane Clinic to have blood tests taken to find out what her level of bilirubin was. I phoned the paediatrician with the results; he was unavailable and I left a message. The nurse who gave me the figures said that the bilirubin level was very high. I was very worried about my daughter and was anxious to get her the treatment she needed as quickly as possible. When my paediatrician phoned me a few hours later, he told me that her levels were normal and explained that there is a table they use to determine the level of bilibrium and the age of the baby. Chloe's levels were fine and no treatment was required.

 

Babies with jaundice tend to want to sleep a lot; they will sleep past their feeding times and can be prone to dehydration. A baby with jaundice should be woken up and fed frequently. This will speed up his/her recovery time.

 


Umbilical cord care

Your baby’s umbilical stump will fall off during the first few weeks. When changing the nappy and after a bath, give the base of the cord a gentle clean with surgical spirits. Fold the front of your baby’s nappy below the navel so it doesn’t irritate or moisten the area around the stump. If the skin at the base of the stump turns red, is painful when touched, or has a bad odour, this may signal an infection that needs immediate medical attention.


Colic

Generally, a baby is deemed colicky if he shows sudden and unexplained outbursts of crying in accordance with the ‘rule of 3s’ – crying at least 3 hours a day, for 3 days a week, beginning within the first 3 weeks of life. Colic usually starts from about 3 weeks of age. It’s painful to hear and stressful to deal with, since the most you can do is try to calm your baby until his colicky phase passes – usually by 3 months of age. Colic can also be a broad label for other discomforts that the baby might be experiencing like abdominal distention, reflux or even extreme growth spurts. Your clinic nurse can guide you through these phases.

 

Fingernails and toenails

Babies’ fingernails can be soft and pliable, yet very sharp at the edges. Babies can scratch themselves if they are not kept trimmed. Learning about how to cut your baby’s little nails might take a while and you may feel uneasy at first. Here are some tips to help:

  • Trim the nails when your baby is sleepy and relaxed. After a bath is a good time when the nails are soft.
  • Having a second pair of hands can be helpful.
  •  Try to keep your baby relaxed and calm – talk calmly or sing to your baby as you cut the nails.
  • Use small baby nail scissors (with rounded end) or an emery board.
  • Cut your baby’s nails straight across and avoid cutting down the sides of the nails, as this can cause ingrown nails and infections.
  •  Don’t use your teeth to bite off nails as the bacteria in your mouth can cause infections.
  • Avoid tearing the nails as they can easily tear back too far.
  • If you want to use clippers, use ones made for babies.

Many young babies get a small infections next to a fingernail or toenail (called paronychia). Usually this clears away without treatment (or with using a little water-based antiseptic cream or lotion, or saline solution) but sometimes an infection can spread into the skin of the finger or toe around the nail and there can be swelling and redness of the skin. If this happens you need to have it checked by your clinic nurse, paediatrician or GP as your baby may need an antibiotic.

 

Cradle cap

Cradle cap is a yellowish, patchy, greasy, scaly and crusty skin rash that occurs on the scalp of newborn babies. It is caused by overproduction of the sebaceous glands. You can apply olive oil, or other vegetable oil, or baby oil to soften the scales one evening and wash the oil off the next day.

Gently lift off the softened scales with a soft brush (such as a soft toothbrush), a fine-toothed comb or fingernail. If some of the scales remain sticking to the surface of the scalp, use the oil again the next night. Do not use much pressure to scrape off the scales as this could damage the underlying skin. If the condition does not improve see your clinic nurse, paediatrician or GP.

 

Hernia

Your baby’s umbilicus (belly button) may take several days to heal fully, and many babies have umbilical hernias which are lumps underneath their belly button. It may swell when the baby cries.

This is a small gap in the ‘tummy’ muscles and it will nearly always go away in time. It does not need treatment and does not cause health problems.

 

Sometimes small hernias develop in the groin (inguinal hernias). A small lump can be felt, especially when the baby is crying. These are much more serious, and your baby should have medical attention as soon as possible.

 

Posseting

Some babies reguritate some milk after feeds. If they are growing well and are happy this is nothing to worry about. If your baby brings up milk in big volumes, is experiencing discomfort much of the time or is not gaining weight, you need to see your clinic nurse, paediatrician or GP. (See the topic Reflux in the Medical A-Z for more information.) 

 

Spots

Most babies develop spots on the face, chest and back when approximately 3 weeks old. They are called milia and may look like acne – red spots with white centres. They are due to maternal hormones and gradually disappear over the next couple of weeks. They require no treatment. 

 

Sticky eyes

Some babies have a sticky eye due to a blocked tear duct (usually on only one side, but sometimes on both sides). It usually clears on its own by the age of 2 months. Ask your clinic nurse how to manage this. It is usually not serious.

 

 

 

Sleep

‘Does your baby sleep through the night?’ is one of the most frequently asked questions. Bleary-eyed parents always answer ‘No!’

 

Newborn babies don’t know the difference between day and night and their tiny tummies cannot hold enough milk to last them more than 2 or 3 hours. Only as they get older – about 3 months – can they sleep for longer stretches.

 

A newborn may sleep as much as 16 hours a day – sometimes less, sometimes more. The lack of pattern can be a source of frustration for parents. Be patient, a routine gradually emerges from about 6 weeks. Try to get as much support as possible for your own lack of sleep.

 

It is advised that a baby should sleep on its back to reduce the incidence of SIDS. Whether the baby sleeps in your bed or a bassinet next to you or in its own room is a parent’s choice. Remember to keep safety in mind.

 

Guarding against SIDS

Sudden infant death syndrome (SIDS) – when a baby unexpectedly stops breathing and dies in his sleep – occurs in 1 in 1400 American babies a year, usually before 6 months of age. There is no known cause of SIDS, but research indicates that certain precautions lower the risk. Be sure to:

  • Always put your baby to sleep on his back.
  • Make your home a smoke-free environment, and don't allow others to smoke around your baby.
  • Leave bedding like comforters or pillows out of your baby’s crib.
  • Keep the temperature in your baby’s room between 18°C and 22°C, so your child won’t overheat while sleeping.

Breastfeeding is thought to reduce the risk of SIDS as it strengthens the immune system.

 

When to call the doctor

While many harmless and common newborn behaviours cause parents great concern, it’s always best to check with your clinic nurse or paediatrician if your infant:

·         Doesn’t raise her head when lying on her stomach after the first few weeks

·         Doesn’t seem to respond to sights or sounds

·         Exhibits a lack of energy or alertness

·         Refuses to feed

·         Is vomiting (as opposed to spitting up, which is normal!)

·         Is not urinating

·         Has a weak, high-pitched cry

·         Has a pale, blue, or mottled complexion

·         Has diarrhoea (copious, watery stools, sometimes with mucus visible)

·         Has a fever

·         Has an irregular breathing pattern

 

Body temperature and fever

Young infants do not control their body temperatures as well as adults do. Their hands and feet may quickly become mottled or even bluish when they are cold, and they may feel excessively warm after only a short time if bundled too snugly or after being out in warm weather. Quite often, simply unbundling or warming them up will bring an otherwise healthy baby’s body temperature back to normal. However, it is especially important for the parents of newborns to recognise fever. This is because newborns do not fight infection as well as older children, and fever can be a sign of infection. In general, it is best to avoid bringing them into contact with friends and family who are sick – especially if they have a fever. Remember that many illnesses are spread by direct contact; making sure that people wash hands and cover their mouths and noses can decrease the likelihood that a baby will become sick. When fever is a concern in a newborn, it is important to take the temperature with a thermometer and discuss the situation with a doctor.

 

 

Call immediately if you notice any of the following in your baby:

  • A fever higher than 38°C
  •  Difficulty breathing
  •  Forceful or repeated vomiting
  • Persistent diarrhoea
  • Blood in his urine or stool
  • Frequent, inconsolable, or high-pitched crying
  • Persistent lethargy
  • Yellow- or orange-hued skin or eyes
  • A rash, blisters, or irritated skin
  • White patches in his mouth, which may indicate thrush (the condition isn’t serious, but it can make your baby uncomfortable and unable to nurse or bottle-feed well)
  • Any unusual discharge from his eyes, nails, navel, or genitals