109. Common Infant Concerns

There are quite a few common concerns when it comes to new infants. Sometimes as a new parent it’s hard to know what is or isn’t normal. This section takes a look at the most common concerns that arise.

There are a few different types of infant jaundice. The most common type of jaundice occurs at 2 to 3 days of life. After birth, babies have extra red blood cells they do not need. As these break down, they turn into a substance called bilirubin which your baby’s body gets rid of in the first few days in black and green stools. Too much bilirubin makes your baby’s skin, and sometimes the whites of your baby’s eyes look yellow (jaundiced). You can help prevent or reduce this type of jaundice by feeding your baby often for as long as she or he wants. Your baby should be eating enough to have the right amount of wet and dirty diapers and to be gaining weight (see Part 5 Feeding Your Baby for more information).

Some jaundiced babies are sleepy and may not feed well. If you are concerned about your baby:

• wake and feed your baby at least every 3 hours (for a total of 8 to 12 times in 24 hours)
• call your doctor, public health nurse, or midwife

Healthcare providers will assess your baby’s level to see how much bilirubin is circulating in your baby’s body. A jaundice meter may be used to tell how much bilirubin is in her body. It is placed on her forehead and uses a flash of light. Testing with the meter only takes a couple of seconds and does not hurt the baby. Some may need a blood test.

While this type of jaundice is very common, sometimes it needs to be treated. If your baby needs treatment, she may need to be in the hospital for a few days under special lights (phototherapy). Do not put her in the sun.

Sometimes a baby will become jaundiced in the first 24 hours of life. This type of jaundice is usually because of a difference between the mother’s blood type and the baby’s blood type. If your baby is jaundiced this early, contact your healthcare provider right away as phototherapy is often needed.

A less common cause of jaundice is liver disease. Your baby must be seen by a doctor, if at 14 days of age, your baby is jaundiced (skin and whites of eyes are yellow) and your baby’s stool is pale (grey) or the urine is dark (brown).

Diaper rash is a red area or rash on your baby’s diaper area.
If your baby develops a diaper rash:

• change diapers often
• wash your hands before and after each diaper change
• avoid using perfumed baby wipes, soaps and fabric softeners
• expose the diaper area to air for 10 to 15 minutes at least 3 to 4 times a day
• apply a thin layer of a zinc-based cream to the area with each diaper change
• try a different brand if you are using disposable diapers
• check that her plastic pants are made from a breathable material if you are using cloth diapers

Call your healthcare provider if the diaper rash:

• Lasts longer than 48 hours
• Looks like blisters
• Has signs of a yeast infection such as; looks like red dots or bumps and the inside of your baby’s mouth has a white coating that can’t be wiped away with a wet cloth

Newborn rash is a blotchy, red, pinpoint rash found anywhere on the body. It is common in the first months of a baby’s life. The cause is unknown. Although the rash may look unattractive, it is normal, needs no treatment and will pass with time.

Other causes of rashes may be:

• overheating
• soap, bleach or fabric softener in clothes
• wet diapers, plastic pants and mattress covers
• diapers being worn too long
• perfumed products
• allergy
• illness
• insect bites

Cradle cap is thick, greasy or flaky scales on your baby’s scalp. It is caused by normal changes in your baby’s skin. Although cradle cap won’t harm your baby, you may want to treat it.

• Gently massage a small amount of mineral or olive oil onto your baby’s scalp.
• Allow the oil to soak in for several hours or overnight.
• Rub gently with a towel or soft brush to loosen the scales.
• Wash the scalp with a mild shampoo. Rinse well.
• Repeat if necessary.

Call your nurse or doctor if you’re concerned about your baby’s cradle cap.

Babies may sneeze often to help clear their nostrils. This is common in the first few months. It doesn’t mean your baby has a cold.

If your baby has a plugged nose that interferes with feeding try

• extra humidity in your home. Note: If you use a portable humidifier, it will need regular cleaning and disinfecting as using an unclean humidifier can lead to breathing problems or allergies
• saline nose drops (check at a drugstore or make your own)

Recipe for nose drops

• Mix 2.5 mL (1/2 teaspoon) of salt to 250 mL (1 cup) of boiled, cooled water.
• Place 1 or 2 drops into each nostril with an eye dropper before feeding.
• Do not use a bulb-shaped nasal aspirator. It can make congestion worse.

Your baby may get gas or air bubbles during or after feeding.

Your baby may need to burp:

• after feeding on the first breast
• after drinking about half of the formula
• if she or he becomes restless, cries or pulls away during a feeding
• at the end of a feeding

To burp your baby:

• support your baby’s chest and chin
• gently rub or pat your baby’s back
• use different positions (for example, holding your baby upright or across your lap)

Hiccups are very common and often bother the parents more than the baby! Sometimes changing your baby’s position or getting your baby to suck will help stop the hiccups. Hiccups will not harm your baby.