Top to toe guide to newborn health

Sticky eyes, sore bottoms or a face covered in spots may not be quite what you’d envisaged for your new baby, but they’re all par for the course and easily treated

Looking after your new baby takes a lot of getting used to, not only have you suddenly got a brand new person in your life, but also a whole new set of illnesses to deal with. We’ve come up with some common newborn health problems, with expert advice on how to treat them and whether it’s worth consulting your doctor.

Scaly bits

Thick yellowish scales on your baby’s scalp, known as cradle cap, is caused by an over-production of sebum, an oily substance that is secreted to keep the skin healthy. Although it can be unsightly, it’s completely harmless, and shouldn’t cause irritation.

What you can do

Cradle cap will generally clear up on its own but it’s easy to treat. Gently massage some petroleum jelly or olive oil into your baby’s scalp in the evening, and leave it on overnight – make sure you put a towel over her sheet to protect the mattress.

In the morning, wash her hair with baby shampoo and rinse thoroughly, then brush gently with a baby hairbrush. Some of the scales will come away, but you’ll probably have to repeat the process for several days until they have all gone.

Don’t try to remove any scales that are stuck, as this could hurt her and cause the scalp to become infected. 

Does she need to see a doctor?

If your baby’s cradle cap is becoming red and irritated, or appears to be infected, take her to see your GP. You should also seek medical advice if the condition spreads beyond your baby’s scalp to her face, armpits or nappy area.

Sticky eyes

Your newborn can produce a yellowish or creamy discharge from her eyes which can be caused by bacteria picked up in the birth canal, or by poor hygiene. 

What you can do

‘Bathing your baby’s eyes regularly with cooled, boiled water is the best way to deal with sticky eyes,’ says M&B midwife, Helen O’Dell. Wash your hands before you begin, then take a piece of clean cotton wool, dip in the water, 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. Instead of water, you could use breastmilk if you’re breastfeeding, as it contains powerful antibodies which help fight infection.

Does she need to see a doctor?

If you clean your baby’s eyes regularly, the problem should clear up within a couple of days, but if it doesn’t, consult your GP.

Spots and rashes

Your newborn may develop spots, known as milia, as the glands in her skin adapts to life outside the womb. These can look nasty, but they’re harmless, and should soon clear up without treatment. 

What you can do

Leave them alone! You don’t need to do anything apart from keeping her skin clean with warm water and cotton wool. The spots will gradually fade on their own so don’t be tempted to squeeze them.

Don’t let your baby become overheated and if she does, remove a layer of her clothes to help her cool down. If her skin seems red and irritated, you can soothe it by bathing her in tepid water.

Does she need to see a doctor?

If a skin problem persists, or it distresses your baby, talk to your midwife, GP or health visitor.

Weepy tummy button

The stump of your baby’s umbilical cord should come away within the first week or so. It 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, which is nothing to worry about. 

What you can do

If your baby’s cord stump is sticky, clean it gently with cotton wool and cooled, boiled water. Turn the top of your baby’s nappy down exposing the cord to the air and keeping it clear of urine, to minimise infections. Don’t pull at the cord – it will come off when it’s ready.

Does she need to see a doctor?

Sometimes a little piece of inflamed tissue remains in the navel and weeps. This common symptom, known as a granuloma, is harmless, and your midwife or GP will touch it with a silver nitrate stick, which is painless, to make it shrivel away.

Speak to your midwife or doctor if you notice that the cord is particularly sticky or weepy, if the skin around the navel is red and sore, or if there are fresh drops of blood coming from the navel, as these are all signs of an infection.

Peculiar poo

Your baby’s first bowel movement will be a greenish-black, tar-like substance called meconium. After that, her stools will probably be runny and mustard yellow in colour. Breastfed babies tend to have runnier stools than bottlefed babies and some babies have only one or two bowel movements a day.

Or even go for a day or two without a poo, while others fill their nappies after every feed. If your baby has diarrhoea, her poo will be very liquid, green or contain mucus, and she may have a sore bottom.


What you can do

If your newborn has diarrhoea:

• Feed her as normal as she needs plenty of fluids.
• Wash your hands thoroughly after changing her nappy to avoid spreading an infection.
• It can help to give her cooled, boiled water in addition to normal feeds, but this should only be done if advised by your midwife or doctor.

Does she need to see a doctor?

Diarrhoea is usually caused by an infection, and needs treatment. Always seek medical advice immediately if she develops diarrhoea, as young babies can become dehydrated very quickly.

Sore bottom

Small spots or red patches around her groin or bottom, which look sore and feel sensitive to touch, are normally caused by nappy rash, triggered by bacteria from your baby’s poo. It releases a chemical called ammonia, which irritates and burns the skin. 

What you can do

• Change your baby’s nappies frequently, and as soon as they are soiled. Even super-absorbent nappies should be changed as soon as you know they are wet.
• Wipe and dry your baby’s bottom at each change. ‘Warm water and cotton wool is the best thing to use for cleaning sore bottoms. Make sure your baby is completely dry before you put her nappy back on,’ says Helen.
• When you can, leave your baby’s nappy off for a while – but remember to lie her on a thick towel in case of 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 it helps.

Does she need a doctor?

If nappy rash doesn’t clear up in a week, your baby may have a yeast infection, such as thrush, which turns the skin a fiery red colour with a scaly edge. In this case, your doctor will need to prescribe an anti-fungal cream.

Sickness

Almost all babies bring up some milk after a feed, especially while they are being winded. Actual vomiting usually happens a while after feeding, and there will be large amounts of curdled milk which may smell nasty.

What you can do

If your baby is vomiting, you need to seek medical advice, but slight post-feed sickness can be eased if you:

• Handle her 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 and doesn’t get filled with air.
• To help her avoid gulping in air, don’t let her cry too much before a feed.

Does she need to see a doctor?

Vomiting can be caused by trapped air in your baby’s stomach, but it can also be a sign of infection if it happens frequently. If your baby seems unwell and has a fever or diarrhoea, consult your doctor immediately.

You should also seek medical advice if your baby projectile vomits, is violently sick, or spurts milk out at the end of a feed with real force. In some cases, a small operation is recommended to strengthen a valve in the stomach to stop milk coming up.

Snuffles

Newborns have very narrow nasal passages, and tend to produce a lot of mucus, so snuffles are common. If she also seems chesty, it’s probably due to excess fluid in her lungs which has come from the womb.

Your newborn is unlikely to catch bugs, such as coughs and colds, as she still carries your immunity to infections, which will protect her until she’s around three months old.

What you can do

Gently clean any crusts around her nostrils with warm water, but don’t poke anything into her nose, and feed little and often, as babies are usually not able to feed as comfortably when their noses are blocked. Try taking her into a steamy bathroom to help unblock her airways so that she can breathe more easily.

Does she need to see a doctor?

If she is wheezing heavily, see your doctor as she may have a chest infection.

Keeping it clean

In the early weeks, you don’t need to bath your baby every day, a couple of times a week is fine, but good hygiene is still important.

• On the days you don’t bath your baby, you can top and tail her – wash and dry her hands and face, then clean her nappy area with damp cotton wool and dry thoroughly.

• When you change your baby girl’s nappy, always clean from front to back, to avoid spreading germs from her bottom to her vagina.

• If your baby’s nappy waistband is too high, fold it over to avoid dampness and chafing around her cord stump.

• Don’t try to wash inside your baby’s nostrils or ears, and don’t try to clean inside a baby girl’s vagina, or under a boy’s foreskin.

• Clean your baby’s eyes (see Sticky eyes, above).

• Always change your baby’s nappy as soon as it’s dirty, so her bottom doesn’t become sore.

• Wash your hands with soap after nappy changes to prevent infection spreading.