Taking care of your newborn

Taking care of your newborn

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A patient of mine, a new mom, came for consultation because she was very worried. In fact, she even decided to seek a second opinion about her newborn. She said she needed the second consultation as a confirmation of what I had earlier told her, which was quite different from what she had been told by grandma.

She expressed worries that her two-week old baby boy jerked or startled when anybody talked or moved around him. She had been told by grandma that the child was suffering from fright or panic, meaning that something or someone had frightened the baby and that the fright was still inside of him and would affect him later in life.

Needless to say, this is not true, medically!

The simple medical explanation is that a newborn that startles or jerks with every sound or movement is hearing well. It is simply a response to sound, touch and movement.

So many new challenges can make new moms feel insecure, especially if they are surrounded by ‘expert moms’ who are eager to give all kinds of advice about child rearing.

When a baby is born, it’s common for the elders to offer the new mom advice and support. The help they offer for breastfeeding, for instance, is very important because some women do experience difficulties at first and family support can help them keep going when they want to quit.

But they may also get some advice about practices that are based more on fairy tales than on modern medicine.

I do advise new moms to come along with some family members for paediatric appointments, so that they can hear firsthand from the doctor why some traditional practices have been replaced by sound medical recommendations.

This is why a colleague once called me a tripartite doctor, a terminology he coined, meaning a doctor that sees three patients in one consultation. As you are seeing the baby, you are also seeing the mother or father and probably the grandma.

I have therefore put together these simple tips to help new moms. Read on!

Soft spots

The soft spots (fontanelles) on top of a baby’s head are there so that the baby’s bones can move a little, so that the baby can more easily through the birth passage when s/he is being born. These spots will usually close up in the baby’s first year or so.

Sometimes, a fontanelle swells when the baby is crying and goes flat when the crying stops. It can also be sunken if the baby is dehydrated.

Reflexes

Babies do some things automatically without knowing they are doing them. These are called reflexes. For example, if something is put in their mouths, they suck on it (sucking reflex); and if something is put in their hands, they hold on tight (grasp reflex). If they are startled or upset, they fling their arms out and throw their heads back (startle reflex).

Breast bud

Babies are often born with large genitals and breasts; and sometimes, ‘milk’ even comes out of their breasts. This swelling is due to the mother’s hormones and it is normal (even for boys), though it does not last long.

Don’t try to squeeze any milk out of the breasts, as too much pressure can sometimes cause an infection. If the breasts become larger, firm and tender, and your baby seems unwell, there could be an infection, and you would need to take your baby to the doctor.

Cradle cap

Cradle cap is a yellowish, patchy, greasy, scaly and crusty skin rash that occurs on the scalp of recently born babies. You can put on olive oil or baby oil to soften the scales and then wash off the oil the next day.

Gently lift off the softened scales with a soft brush. If some of the scales are 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 cause wound on the underlying skin.

Rashes

Most babies have spots on their faces and often on parts of the body in the first few weeks. They are called milia and can look like acne, that is, red spots with white centres. They are not acne and they do not need any treatment.

They seem to be a reaction to the skin being exposed to air rather than to the fluid in the womb (uterus) before birth. Sometimes, the spots come when the baby gets hot or has been lying on the affected side. Some may also be the reactions of the skin to certain baby cream, lotions, etc.

Diaper rash

This is a red and painful rash in the diaper area. Rashes can be caused by irritation from dampness of urine or bowel movement on the skin. To prevent diaper rash, wash your hands before and after changing diapers. Keep the skin dry by changing diapers as soon as they are wet or soiled.

Wash the diaper area with lukewarm water and dry well; or, preferably, use a baby wipe.

Take the diaper off and expose the area to the air for 10 to15 minutes, three times a day. You can lay your baby on an absorbent towel and play with her during this time: When the diaper area is clean and dry, rub on a thin layer of zinc-based cream.

Regurgitation

Lots of babies have hiccups after feeds. This is normal. Some babies spill some milk after feeds. If they are growing well and happy, this is nothing to worry about. If the baby is bringing up milk in big spurts much of the time and not putting on weight or is miserable a lot of the time, you need to see the doctor.

Remember, never shake a baby or throw a baby up! It can lead to seizure, brain damage and death.

To be continued

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