Baby health FAQs
Baby health FAQs
It's always advisable to see a GP or health visitor if you're worried about your new baby. Chances are, you'll find reassurance. But here Dr Jo Nixon - a GP in a busy London practice – answers some of the most frequently asked baby questions she hears.
Q: Why is my baby is always crying?
A: My most important task is to make sure a baby isn't crying because he's seriously ill. That's why I always check whether the baby is unwell, drawing up his legs or vomiting. It's useful to know what kind of birth the mother had, and whether she's having any feeding difficulties. I'd also need to know a little bit about what else is going on - if you're a single mother struggling to cope on your own, a few hours of crying in the night can seem unbearable. But if the baby is well, feeding normally, growing and intermittently happy – although sometimes crying for long periods - you've probably got a perfectly normal baby. If that's the case, I'd encourage the mother to have a chat with the health visitor and to talk to other mothers. Some babies just cry more than others.
Q: Why does my baby always have a cold?
A: This is very common – especially in winter babies, or babies with siblings at nursery or school. There really isn't much you can do about a cold – though sometimes parents worry that the baby is having difficulty feeding. If that's the case, I reassure them that the baby will breath through the mouth when not feeding and I may prescribe saline drops to unblock the nose specifically and only for feeds – just drop them into the baby's nose 10 minutes before a feed. Sometimes, babies seem to have one cold after another and parents worry that some kind of immunological deficiency is the underlying cause. However, colds are rarely an indication of babies with immunity problems.
Q: My baby's got a rash, what is it?
A: People often worry about rashes being meningitis – though with meningitis, there's not always a rash and if there is one, the baby would usually be unwell too. Characteristically, the rash of meningitis is one which does not blanch (disappear) with pressure. Babies have incredibly sensitive skin, so some rashes are temperature-related or a reaction to perfumed and coloured baby products, which can act as irritants. (I believe you should use only Oilatum® or water with young babies.) There's also milia - tiny white spots that appear on the face about two weeks after the birth – and other spots that could be related to the mother's hormones still circulating in the baby. All of these usually clear up by themselves within six weeks. People often come about cradle cap too and I reassure them it doesn't itch or distress the baby at all – it's far more distressing for parents! You can use olive oil to get rid of it, or just leave it.
Q: Will I be able to get an epidural?
A: If you think you might want an epidural ask your midwife during the pregnancy whether they are available 24 hours a day in your birth unit. Once in labour the best advice is to try the different methods of pain relief available. Start with natural pain relievers such as water, massage, or TENS, then move on to forms such as gas and air and see how you feel. Many women find these forms of pain relief enough. However, if you are having a long or very painful labour and decide you want an epidural ask your midwife for one as soon as possible. An anaesthetist has to come to give you the epidural and if they're busy giving epidurals to other women or are in theatre for a caesarean there could be a delay. It takes around 15 minutes to put the epidural in and another 15 minutes to fully work. If it looks like you might deliver before or soon after the epidural is working the midwife may suggest you try alternatives such as gas and air instead.
Q: My baby doesn't sleep enough/my baby sleeps all the time!
A: Sleep is a huge issue for new parents and it's important to establish whether the baby is acting differently to normal. I'd be concerned if he or she used to be much more lively but has been unwell and become incredibly sleepy. However, if parents come to see me with a baby that has always slept a lot and is otherwise well, it's likely to be a normal baby that simply likes to sleep! At the other extreme, babies who hardly sleep at all are rarely a cause for concern – except that it can be incredibly stressful for the parents. There's seldom anything medically wrong with a wakeful baby, but I'd suggest looking for patterns, and maybe talking to the health visitor and other parents about routines, feeding and sleeping regimes.
Q: My baby's weight has fallen below its centile line!
A: We do plot a baby's weight - and that can lead to a lot of anxiety when the baby doesn't grow along its centile line. If you're having your baby weighed every week, the weight will be on and off the line – but if the baby is happy, feeding well and generally gaining weight then I tend to be reassuring. Babies often gain a lot of weight in the first couple of months and then tend to grow at varying rates. Some babies are genetically determined to be smaller or larger than others. You have to look at the broader picture. If the baby is bright, alert, healthy and meeting its developmental milestones, then there's unlikely to be a reason to worry.
Q: What can I do about this persistent cough?
A: Some babies cough when they have reflux – which is when milk comes back up making the baby 'spit up'. It's relatively common in newborns, mainly down to poor coordination of breathing and swallowing and the fact that the baby spends lots of time lying down. It usually disappears when the baby starts eating solid foods and sitting upright. If the baby is bottle-fed, we may possibly talk about thickening up the milk. We'll also talk about feeding positions and maybe holding the baby upright for 20 minutes after a feed. There are medicines available in more severe cases. Another common cause of a baby's cough is RSV (respiratory syncytial virus) – most children will have been exposed to this by the time they're two and you especially see it in the winter months. RSV often starts with a temperature, a runny nose and a cough. It's usually a self-limiting infection that requires no treatment – it's usually gone in two weeks. Sometimes, especially in vulnerable babies, like those born prematurely or with heart and lung problems, it can develop into something more serious like bronchiolitis or pneumonia. Parents often worry about asthma when they hear a baby cough - and it's something we may look into if there's a very strong family history. With asthma, it tends to be a persistent dry cough at night. On the whole though, it's unusual for a baby to be diagnosed with asthma in its first year of life.