Common newborn problems – a "top to toe" guide:

By Chris ToumpasBabies27 Aug 2015

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Head Shape:

Babies may develop moulding during delivery, this is a funny head shape. Moulding can look abnormal to parents. It occurs as a baby has soft, movable bones in order to fit through the birth canal. Babies that are in the breech position before birth can have a flat or rounded area on top of the head and pointy area at the back. This results from the head resting at the top of the uterus. Moulding quickly resolves soon after birth. A paediatrician will review moulding to check the skull bones are growing normally.

 

Cephalhematoma:

A cephalhematoma is a bruise on the outside of a baby’s skull. It is due to bleeding between the skin and the outside of the skull. They usually occur with instrumental deliveries (e.g. forceps). They can be large, but do not cause pain. They resolve over weeks.

 

Cradle Cap:

This a yellow, waxy build up on the baby’s scalp, eye brows or limbs. It is very common and is caused by an accumulation of oil from oil or sebaceous glands. It can be treated by washing with warm water and moisturiser wash or baby oil.

 

Sticky Eyes:

Newborns often develop a discharge from one or both eyes. This is usually due to a blocked tear (lacrimal) duct. Babies make tears all the time to lubricate their eyes. The fluid flows down the tear duct into the nose. The tear duct is very thin in newborns and can easily become blocked by milk or mucous. Babies mostly breathe through the nose. Sneezing helps clear the nose and tear duct. Sticky eyes will respond to washing with saline. Tear duct massage using gentle finger pressure vertically on the side of the nasal bone three times a day. Blocked tear ducts do not usually require antibiotics. If there is redness around the eyelids or the conjunctiva, an antibiotic may be prescribed by your doctor.

 

Sleep:

It is recommended that babies sleep on their back for SIDS prevention. There is a great variation in the pattern of sleep in the first few months of life. Most newborn babies sleep for about two to three hours at a time. Sleep is affected if a baby is unsettled which causes concern for parents about development. Babies that do not sleep constantly do get enough from short naps. Child Health can provide practical support with sleep and settling. It is a good idea to see your doctor if the unsettled pattern persists.

 

Dummies/Pacifiers:

There is much debate about the use of dummies. Sucking is very soothing for babies. Some babies respond to a dummy, others reject them. It is worth trying as a settling technique. No particular brand of dummy is better than another. There is no increased risk of abnormal dentition due to dummies. Some concern has been raised about dummies interfering with breast feeding. A recent clinical trial of a large number of babies using or not using dummies showed no difference in the incidence of breast feeding at 6 months.

 

Temperature control:

Babies can easily become too cold or too hot. It is important to have good ventilation around newborn babies (e.g. around 22-24 degrees). Babies release heat through their head, so it is important to leave their head exposed. Good air circulation helps babies stay cool on hot days. Cotton is generally preferred for baby skin. In general, dress your baby with one extra layer compared to you.

 

Jaundice:

Jaundice is a yellow colour that occurs commonly in newborn babies. It occurs in 60-80% of newborns. It is an accumulation of bilirubin, a product of broken down blood. Jaundice is seen in the skin or white parts of the eyes. Most jaundice is normal and does not cause problems. Physiological jaundice starts on day two to three of life, peaks on day five to six, then resolves over a couple of weeks. Doctors and nurses monitor jaundice carefully in case further tests are required. Tests are required if the level of jaundice is high or if it begins in the first 24 hours of life. Indirect, natural light can help reduce jaundice by breaking down bilirubin.

 

Rashes:

Babies can get various rashes, many are common and resolve without problems or can be treated easily once reviewed by a doctor or child health nurse. Babies can get facial acne from hormonal stimulation of the sebaceous glands. They can get a dribble rash from regurgitated milk or saliva. They can also get a heat rash on the neck and trunk from dry and warm conditions. Allergies and eczema can also cause rashes too and may be associated with other things like vomiting, watery stools or a family history of allergies. Various infections can cause rashes on the skin. Thrush can cause a white coating to appear on the tongue. This coating can be sticky or red underneath, unlike milk which is easy to remove. It is important to see a doctor if there is a concern about rashes due to allergies or infection. Babies commonly have birthmarks. Some can be seen at birth while others take weeks or months to show.

 

Umbilical Cord:

The umbilical cord is cut at birth. Usually, Dad will be asked if he would like to cut the cord. There is a small residual piece of umbilical cord remaining with a plastic clip on the end to stop bleeding. The cord quickly dries up and becomes small and hard. The cord and clip usually falls off on about day 10 to 14. It is important to keep the cord clean and dry and remove any debris. It helps to fold the nappy down under the cord.

 

Breech Hips:

Babies born breech have a higher risk of hip problems (dysplasia). All babies have their hips examined in hospital, this is especially important in breech babies. Female breech babies have a slightly increased risk of problems compared to males. Most babies do not require treatment.

 

Circumcision:

Circumcision has been practiced for thousands of years. It is controversial topic. It was almost routine one to two generations ago. Now, about 10% of male babies are circumcised in the newborn period. Parents may elect to have a circumcision based on their religious beliefs. The Paediatrics and Child Health section of the Royal Australasian College of Physicians and the Australasian Association of Paediatric Surgeons recommend against routine circumcision to reduce medical problems, and certainly not in infants < 6 months of age.

 

Talipes:

Positional talipes (equino-varus) is a common foot condition in newborns. It can affect one or both feet. The foot rests down and inwards, but remains flexible. A doctor will always examine the foot, leg and hips for other problems. Often, some regular, gentle exercises can be used. Talipes usually resolves in the first few months.

 

For more information on common newborn problems, please visit:

Raising Children or Baby Centre

It is important to seek medical advice for any worrying or unusual problems.

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