Top to toe newborn health

Getting used to the world can sometimes be tough for your new baby. But most health worries can be solved quickly and easily

Yellow skin, gooey eyes and a red-raw bottom may not have been among the characteristics you dreamt of for your new baby, but even the most beautiful newborns arrive with a startling array of minor health niggles. With the help of Mother & Baby’s midwife Helen O’Dell, we’ve picked out some of the most common newborn health concerns – and solved them for you.
 

SHE'S TURNED YELLOW

A newborn baby with a yellowish tinge may have jaundice. Your midwife will  check your baby during the first week, as it’s often not evident until a day or two after delivery.

It’s a very common condition and in most cases isn’t serious. It usually resolves itself quite quickly, but your baby will need to be monitored until it clears up.

Jaundice is the result of a high level of a chemical called bilirubin in the blood, which causes the yellowness. (If your baby is Afro-Caribbean, Asian or Chinese she may just have a yellowing of the whites of her eyes, palms and soles.) ‘All newborns are born with an excess of bilirubin and it can take a while for the liver to break it down,’ explains Helen O’Dell. If the jaundice is severe or continues for longer than two weeks, treatment or further tests may be needed.

Treating jaundice

Exposure to sunlight is beneficial. While you’re in hospital, she may receive phototherapy treatment, (placing her on a kind of sunbed under bright fluorescent lights for set periods until the jaundice fades).

If you’re at home with your baby, there are certain things you can do to help as well:

• Feed her on demand. This will make her wee more, flushing any waste products out of her system.

• Breastfeed her, if you can.

• Expose her to as much daylight as possible, preferably with no clothes on. ‘But don’t put her in direct sunlight as she can overheat and get sunburnt very easily,’ says Helen.

SHE'S SO SPOTTY

Babies are rarely born with peaches-and-cream skin. They often develop spots, known as milia, which are caused by the glands in her skin adapting to life outside the womb. These spots may look nasty, but they’re harmless and should soon clear up without treatment.

‘One of the most common forms of milia are yellow pinprick spots, which appear over the nose and forehead,’ says Helen. ‘These are caused by an excess production of oil [sebum], which was stimulated by your hormones during pregnancy.’ As the effect of these hormones lessens, the spots fade.

A light sprinkling of creamy-white spots on your baby’s face or body may also be tiny cysts, which contain a kind of protein called keratin. These will pop and disappear within six weeks.

Blocked sweat glands can also produce rashes of tiny blisters, usually in skin creases or the groin area, where your baby’s skin gets hot.

Stopping the spots

Apart from keeping your baby’s skin clean (use warm water and cotton wool – avoid soap), you don’t need to do anything. You’ll notice them fading gradually on their own as her skin settles down.

If you think your baby’s sweat glands are blocked (when the skin flares up, especially in the creases and groin area), remove a layer of her clothes to help her cool down and don’t let her get overheated. If the rash seems irritated, soothe it by bathing her in tepid water.

SHE'S GOT GOOEY EYES

 Sometimes newborns have a slight yellowish or creamy discharge in their eyes, often referred to as sticky eye. This may be caused by bacteria picked up in the birth canal, or poor hygiene. If you clean your baby’s eyes regularly, it should clear up within a couple of days. If it doesn’t, consult your GP.

Seeing clearly

‘Bathing your baby’s eyes regularly with cooled, boiled water is the best way to deal with sticky eyes,’ says Helen O’Dell.

Wash your hands before you begin, then take a piece of clean cotton wool and dip it in the water. Squeeze it out and wipe one eye from the inner to the outer corner. Do the same with the other eye, using a fresh piece of cotton wool. You could use breastmilk instead of water, as it contains powerful antibodies that help fight infection.

HER BELLY BUTTON'S LEAKING

This is your baby’s cord stump, where her umbilical cord was attached to the placenta. This stump should shrivel, turn black and come away within the first 10 days. The separation doesn’t hurt, and once it has dropped off the navel underneath should be healed.

The stump is usually quite sticky by the time it drops off, and it might leave a slight smear of blood on the cotton wool when you clean it, which is nothing to worry about.

Sometimes a little piece of inflamed tissue remains in the navel and weeps. This is harmless, but your midwife or GP will need to treat it by touching it with a silver nitrate stick to make it shrivel away. This is a quick, easy procedure and won’t hurt your baby.

Stopping the stickiness

If your baby’s cord stump is sticky, clean it gently with cotton wool and cooled, boiled water. A tiny amount of talcum powder dusted on with a cotton wool ball will help to dry it, but don’t shake powder over your baby, as he may inhale it.

Turn the top of your baby’s nappy down to keep the cord exposed to the air and clear of urine, to minimise infections. And resist the temptation to mess with the cord stump – it'll come off when it’s ready.

Speak to your midwife or doctor if you notice the following:

• The cord is particularly sticky or weepy.

• There’s redness in the skin around the navel.

• There are spots in the area.

• Fresh drops of blood are coming from the navel.

HER NAPPY HAS MUSTARD IN IT

 You’ll spend so much time changing your newborn’s nappies you may become a little preoccupied with their contents!

Her first bowel movement will be meconium, a black tarry substance that lined your baby’s bowel to protect it in the womb. After that, her stools will be runny and mustard-yellow in colour. Breastfed babies tend to have runnier stools than bottlefed babies. Some babies have only one or two bowel movements a day, while others fill their nappies after every feed.

If your baby has diarrhoea, her stools will be very liquid, green or contain mucus and she may have soreness around her anus. This is usually caused by an infection and requires treatment. Speak to your doctor immediately, as young babies can become dehydrated very quickly.

Dealing with diarrhoea

If your baby has diarrhoea, do the following:

• Seek advice from your doctor.

• Feed your baby as normal, as she needs plenty of fluids.

• Get into the habit of washing your hands thoroughly after changing her nappy to avoid spreading an infection.

• Sometimes cooled, boiled water can be offered in addition to the normal feed, but this should only be done on the advice of your midwife or doctor.

SHE KEEPS BEING SICK

 Almost all babies ‘posset’ or bring up some milk after a feed, especially while they’re being winded. This is completely normal and usually the quantity of milk is very small, although it may look like a lot because it’s mixed with saliva. ‘Sicky’ babies may bring back milk at every feed in this way, but it’s rarely a problem.

True vomiting usually happens a while after feeding, and the milk will be curdled and may smell nasty. This can be caused by trapped air in your baby’s stomach, but if it happens frequently it can also be a sign of infection. If your baby seems unwell and has diarrhoea or a fever, consult your doctor immediately.

Projectile vomiting is when your baby is violently sick, spurting out milk with real force at the end of a feed. If she does this often, she may be losing nourishment, so consult your doctor. Sometimes, frequent vomiting is caused by stomach reflux that stems from an underdeveloped oesophagus, meaning she’s not always able to keep food down. Your doctor will need to check for this, but it should correct itself on its own within two years.

Projectile vomiting can also be a sign of pyloric stenosis, which is a fault in the muscles between the stomach and bowel. This can be corrected by a small operation.

Preventing posseting

If your baby's vomiting, you need to seek medical advice. But mild posseting can be eased by the following:

• Handle your baby gently after a feed – too much bouncing around can cause trapped air.

• If you’re bottlefeeding, hold the bottle upright to make sure the teat is always full of milk, with no air.

• Don’t let her cry too much before a feed, to prevent her gulping in air.

HER BOTTOM'S RAW

 If your baby has nappy rash, you’ll notice small spots or red patches on her groin or bottom which look sore and are sensitive to the touch.

Nappy rash is caused by bacteria from your baby’s urine and stools, which release a chemical called ammonia, irritating and burning the skin.

Changing her nappy frequently should control it, but if it doesn’t clear up in a week, your baby may have a yeast infection such as thrush, which turns the skin even redder with a scaly edge. If this is the case, a cream will need to be prescribed by your doctor.

Caring for nappy rash

• Change your baby’s nappies frequently and as soon as they’re soiled. Even super-absorbent nappies should be changed once you know they’re wet.

• Wipe and dry your baby’s bottom with cotton wool or a clean muslin square at each change. ‘Warm water and cotton wool is the best thing to use for cleaning sore bottoms, but always make sure your baby is completely dry before you put on her nappy,’ says Helen O’Dell.

• When you can, leave your baby’s nappy off for a while (but lie her on a thick towel to absorb any accidents).

• Use zinc and caster oil cream to soothe the rash. Calendula cream is also effective.

• Try a different brand of nappies to see if that helps.

DOES SHE HAVE COLIC?

All babies cry – it’s the only way they can express themselves. But if your baby regularly cries inconsolably for long periods and draws her legs up as if in pain, she may have colic.

This is a very common condition and there are many different theories about what causes it, but it’s generally thought to be due to excess wind, a cows’ milk allergy or an intolerance of lactose (the natural sugar found in milk).

Colic is usually worse during the first two months. By around 14 weeks, the vast majority of babies have ‘grown out’ of it altogether.

Soothing colic

If you’re bottlefeeding, you may find your baby benefits from teats designed to slow down milk flow and prevent her from gulping down air. ‘Your health visitor or GP may also suggest changing her formula, but only do this on medical advice,’ says Helen.

If you’re breastfeeding, try cutting out obvious wind-producing foods, such as cabbage and beans, from your diet for a while.

Often, the only thing that soothes a colicky baby is motion. Tried and tested solutions include carrying her in a sling, rocking her in your arms, walking her around in her pushchair or taking her for a drive strapped into her car seat.

Massage can also be very helpful. With two fingers, massage your baby’s abdomen in a clockwise motion, using light but consistent pressure. You can use aqueous cream or grapeseed oil (avoid nut-based oils) and keep going for as long as your baby will tolerate it.

By Katy Holland