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Newborn questions

Newborn questions – Parenting Baby is not just letting him grow as it is. There is more to it. Since the start of this site, many parents have written to me about specific newborn questions. This is an unsettling time for all families, especially after the birth of a first newborn. With fewer parents or other relatives, many of the physical and emotional aspects of caring for a baby are no longer taught to new parents. It is for these reasons that we try to answer all the newborn questions in clear and practical terms.

Newborn questions: My baby’s umbilical stump is pretty red and scary looking. Is it infected?

The umbilical stump forms when the cord, that connected your placenta and your infant in the womb, was cut at the time of birth. It takes from one to three weeks for the stump to heal and fall off. At times, you might see a small discharge as the stump heals.

Occasionally, a pink area will develop over the baby’s skin that is irritated by the cord. These are normal findings. You don’t have to be concerned. If you notice that the skin around the cord is bright red, smell a harsh odor around the cord, or see a think discharge of fluid, contact your baby’s doctor. These are signs of an infection which needs prompt medical attention.

Most babies will not develop an infection of the umbilical stump if the area is kept clean and dry. Some doctors recommend the use of rubbing alcohol on a cotton swab twice each day until the cord heals. When bathing the child during the healing process, do not let the bath water touch the stump.

newborn questions

Sponge bathing with a damp cloth is sufficient, and keeping it dry also promotes healing and prevents infection. Your baby’s “red and scary-looking” stump should receive immediate medical attention; however, most of these are found not to be infected when examined carefully by your baby’s doctor or nurse practitioner.

Newborn questions: When I took my baby home from the hospital, I was alarmed that her head was so flappy. What can I do about it?

All newborn babies have floppy heads. This is because the muscles around the neck that eventually support the head take time to strengthen after birth. Also, the baby’s head is large in proportion to the rest of the body. This adds to the floppy appearance.

The important thing to remember is that a floppy head and neck are normal in all babies. By two months of age, the muscles strengthen with development and control of the head is secure. Until then, you can support the baby’s head comfortably with your arm when you hold him in a cradle position or with your free hand when holding your baby over your shoulder.

Newborn questions: How do I prevent SIDS?

Sudden Infant Death Syndrome (SIDS) is a rare condition where a baby, usually under six months of life and healthy, is found dead in a crib. The cause is not known but we think that it is a result of poor coordination between the brain’s control center for breathing and the baby’s lungs.

The good news is that we know a few things that will decrease your baby’s risk for SIDS. Freeing the home of smoking, feeding the baby breast milk, and placing the infant on her back when in the crib have been shown to decrease the incidence of SIDS. Careful research by pediatricians has brought hope to parents that many cases of SIDS are preventable.

It’s amazing that simply changing the position of the baby in the crib, from a tummy down position to a back position, has reduced the number of infants with SIDS by one-half! We once worried that a baby on her back would be at risk for spitting-up and choking.

But, in fact, this is not a problem for most babies and I not recommend “back-to-sleep” as the safest position. If your infant has a condition in which excessive spitting or vomiting occurs, check with your baby’s doctor about the best sleeping position.

Newborn questions: How can I avoid exposing my baby to germs when visitors come to the house?

All parents try to prevent infections in their baby. Although you can’t prevent every infection from spreading to your kid, there are some common-sense things you can do. Ask potential visitors to your home who have a cold, flu, or other contagious illness to postpone the visit until they are well.

They will appreciate your concern for the baby and visit at another time. It’s a good idea for all visitors and caretakers to wash their hands before holding a baby, especially in the first two months of life when your kid is more susceptible t infections.

Young children, who are enchanted when they play and talk to babies, are more likely to have colds and be contagious. Children, by nature, are less inhibited with sneezing and coughing when around others. Their innocence makes them no less contagious. I say all this without wishing that you isolate your baby from relatives and friends.

Certainly, babies need stimulation and parents need a break at times from the demands of child care. But these suggestions for limiting exposure to germs should lead to a balance between isolation and family social activities.

Newborn questions: Is my baby getting enough breast milk? How can I know if she is getting enough? Also, is irregular feeding and milk intake a problem?

There are lots of ways to be assured that your kid receives enough breast milk. If your baby appears satisfied after nursing and sleeps contentedly following feeding, she has probably taken in an adequate amount of milk. Persistent crying and difficulty latching onto your breast may indicate poor intake.

After the first few days of life after your milk has come in, the diaper should be wet from urine about six times each day. Urine from a well-fed baby is colorless or slightly yellow. Dark colored urine, a scant amount of urine, or pink tinged urine (from crystal) may indicate inadequate intake of milk.

Most nursing babies after the first week will have from three to then bowel movements each day; a few will have one every other day. “Breast milk stools” are loose and a mustard-yellow color. Infrequent bowel movements or very small stools are signs of insufficient milk intake. A sudden decrease in urine or stool means a decrease in milk.

One of the most important aspects of a well child visit is a check on your baby’s weight. If you are concerned that your child is not getting enough breast milk, don’t hesitate to call your doctor or nurse practitioner and arrange for a weight check at the office.

Another way to be sure about the baby’s milk intake is to check if your breasts feel fuller before a feeding and softer immediately after nursing. Some mothers find it helpful to actually hear the baby swallow during a feeding and to observe milk in the baby’s mouth.

Most healthy babies do not feed on a strict schedule. In the first few weeks of life, many babies do well with feedings every two hours for some periods during the day. Once your milk is in and your child is nursing well, most babies will feed approximately every three to four hours.

Patterns of nursing are variable in children. What is more important is that your baby appears content, the number of wet diapers and stools are adequate, and that weight gain is satisfactory. When this occurs, your kid will be thriving.

Newborn questions: Why is a newborn’s head so swollen, as if she’s gone ten rounds in a heavy weight boxing match?

The journey through the birth canal is a slow process. To you baby (and you) it may seem endless. Since the head of a newborn baby is very large compared to its body size, the head is molded during the delivery. Newborns often appear with heads in the shape of a football. It’s remarkable to see how quickly head shape returns to normal within one or two weeks.

This “molding” of the head does not have any adverse effect on the brain or other aspects of your baby’s health. Less commonly, a swelling on the back of the head, usually on only one side, may persist for a few weeks after birth. This happens when a small blood clot forms beneath the scalp skin during delivery. Similar to molding, it is not harmful and the odd shape of the head returns to normal.

Newborn questions: My baby’s breathing changes from time to time. Sometimes it sounds too labored and other times too soft. When should I worry?

The breath sounds of a newborn baby normally change at different times of the day and night. You probably notice these changes when your baby is sleeping. It is common to hear the breath sounds suddenly increase in rate for several minutes before returning to normal. Many healthy babies have this breathing pattern.

At another time when your baby’s nose is congested, the breath sounds may be louder than normal. In this case, if the baby is otherwise comfortable and its skin color is normal, there is no need for concern. Occasional sneezing is also common and normal in baby. Hiccups often alarm parents because they are loud and may go on for a long time. Most babies will go through periods of hiccups at some times without any adverse effect on their health. Hiccups and sneezing should be considered as normal entitlements of life!

When a baby’s breathing rate is rapid and noisy and this pattern is sustained for many minutes, the baby may have a respiratory infection. Sometimes, this is associated with a pulling-inward of the muscles between the ribs. If your baby has any of these signs, consult your baby’s doctor or nurse practitioner immediately.

Newborn questions: Can I cause my baby brain damage by pressing too hard on her soft spot?

The soft spot on the top of your baby’s head (also called the “fontanel”) is the place where four bones that make up the front part of the head come together. It takes a year or more for these bones to grow together at which time your baby no longer has a soft spot. This area is not sensitive and you can’t damage your baby’s brain by touching it during bathing, changing clothes, or play. It’s best to treat the soft spot like any other part of the body—with loving care.

Newborn questions: If I tug too hard or lift my baby up by her arms, can I cause a dislocation?

Playing with your baby in a physical way that is safe and enjoyable is always encouraged. A dislocation of an arm joint in a newborn rarely occurs. However, there are a couple of maneuvers of the arms that may cause a temporary dislocation at the elbow. It is usually limited to children between three months and three years old. The most frequent cause of the elbow dislocation is seen when a parent is walking with a toddler and holding on by one hand.

The child becomes distracted or upset and the parent innocently pulls the arm causing the dislocation. The affected limb is held straight down and motionless. Attempts to move the arm causes pain. In an infant, the same thing can be caused by a quick tug of the arm. Although only some children are susceptible to an elbow dislocation, it is best not to test your child!

Whenever a young child is not moving a limb in the usual way, a medical evaluation is indicated. Your child’s doctor will diagnose this condition quickly and, in most cases, will relocate the elbow by a simple maneuver of the arm.

Newborn questions: My baby spits up a lot.  Sometimes I’m not sure if she is vomiting or just spitting up. What’s the difference?

All babies spit up some of their milk some of the time. This is because the ring of muscle that tightens the entrance to the stomach takes time to mature. It should not worry you if your baby is healthy in other ways. By six months of age, most babies cease spitting. When spitting up or regurgitation is frequent and in large amounts, it is called “reflux”. Although reflux is often messy and frustrating t parents, it is usually associated with a healthy and thriving baby.

When your doctor confirms that reflux is the cause of frequent spitting up, she may suggest smaller, frequent feedings, thickening a meal with cereal, and after a feeding, briefly placing the baby on her tummy, with her head and chest slightly elevated, to empty the stomach quicker.

Vomiting refers to more forceful loss of stomach contents. When a baby vomits, the meal is usually brought up with such force that the food is projected forward (“projectile vomiting”). Vomiting is usually of more concern than spitting up. It can be caused by an infection, an obstruction of the intestines, and by other diseases. Vomiting in an infant should be evaluated by a physician if it persists or is associated with other symptoms such as lethargy, poor feeding, fever, or if the vomit contains blood.

Newborn questions: With babies being sent home so soon from the hospital, how can I tell if jaundice is setting in? What do I do if my baby develops jaundice?

Many newborn babies develop a yellow tinge to their skin called jaundice. It is usually due to the baby’s liver when it is immature in the first few days after birth. It starts on the upper part of the body and in some cases progresses down to the legs. Jaundice is rarely a serious problem; it usually resolves by the second week. Some babies develop jaundice as a result of insufficient milk intake; it may be an early clue to an inadequate intake of breast milk.

Jaundice that covers most of the baby’s body from the head to the legs may be due to difference in mother and infant blood types, infection, or a problem with the liver. Your baby’s doctor may want to watch the degree of jaundice with a simple blood test which measures the chemical responsible for the jaundice.

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