Health Problems
In addition to the regular conditions that can affect children of all ages, such as colds, stomach viruses, and ear infections, there are also some problems that are more common during a baby's first few weeks and months. Watching out for these symptoms and problems can help you recognize them early and prevent serious problems from occurring.
Allergic Colitis
Although this condition is not usually serious, babies with allergic colitis often give their parents quite a scare, mostly because the main symptom is having bloody stools. The blood makes parents think that something life-threatening is affecting their baby, but it usually just indicates a simple milk allergy. Most infant formulas are based on cow's milk, and those milk proteins can trigger the allergy. Soy formulas aren't always tolerated well by these babies either, so switching to an elemental formula is usually the best option to treat these infants.
Even though allergic colitis is usually caused by cow's milk proteins, that doesn't mean that breastfed infants can't be affected too. If a mother is drinking milk or eating foods that have milk as an ingredient, the milk proteins can pass into her breastmilk and cause problems for her baby. Simply avoiding milk products and continuing to breastfeed can usually prevent further symptoms.
Birthmarks and Rashes
Birthmarks are not usually a problem, but they are something to be familiar with. The more obvious ones are flat red or pink marks that can be found on your baby's eyelids, forehead, or on the back of his neck. With an official name of salmon patches, more people know them by their more descriptive names, such as stork bites or angel kisses. Unlike many other types of birthmarks, these usually fade by the time an infant is eighteen months old.
Early on, another type of birthmark can look similar to salmon patches. This birthmark is called a hemangioma or “strawberry.” It can start as a flat red mark, but then is likely to grow until your baby is about eighteen months old. After it stops growing, it should then slowly begin getting smaller over the next three to four years. Occasionally hemangiomas require early treatment if they are located on a lip, where they can interfere with your baby's drinking and eating, or in a spot that hinders eyesight.
If your baby's hemangioma begins bleeding, gets big very quickly, or is located somewhere that you think might cause a problem, be sure to see your pediatrician right away. Early treatment with steroids can help them to stop growing.
Newborns rarely have good skin. In addition to the well-known neonatal or baby acne, your baby might have other types of rashes, including:
Heat rashes or prickly heat — small bumps, most commonly on a baby's neck, chest, upper back, and any other areas covered by clothing
Erythema toxicum — blotchy, red areas that may show up in a baby's first few days
Acrocyanosis — bluish color on a baby's hands and feet
Epstein's pearls — small, white bumps on the roof of your baby's mouth
Sebaceous gland hyperplasia — tiny, yellow bumps on a baby's nose
Most of these rashes don't require treatment and go away on their own, but you should talk to your pediatrician if you think that they are severe or aren't going away.
Fever
Infants normally have higher temperatures than older kids and adults, but a real fever is never normal. Although many experts don't consider a baby to have a fever until her temperature is 100.4ºF or higher, a temperature above 100ºF might indicate a problem in the first few weeks, especially if your baby is very fussy, isn't eating well, or has other symptoms. Because she may not have many other symptoms when she is sick, any newborn with a real fever should be considered to have a medical emergency and needs immediate care. You should talk to your pediatrician about what she considers to be a fever and always get the baby's rectal temperature if you suspect that her temperature is too high.
A fever is simply one symptom or sign that your baby is sick. It is possible to be deathly ill and not have a fever, so don't use your baby's temperature as your only way to judge whether your baby needs medical attention.
Jaundice
As you learned in Chapter 3, jaundice usually begins during day two to three of a baby's life, peaks by day four or five, and then gradually goes away by the end of the first week. Sometimes jaundice may not begin until later, in which case it is usually caused by breastmilk. With a much later peak, in a baby's second or third week, it may also linger much longer, sometimes as long as two to three months. If your baby is otherwise well, lingering jaundice is not usually a reason to stop breastfeeding, although you should keep in touch with your pediatrician.
Jaundice is not always normal, though. There are some conditions, including blood and liver disorders that cannot always simply be observed until they go away. That is why it is a good idea to talk to your pediatrician when your baby is jaundiced, especially if she has other symptoms.
Pyloric Stenosis
Although most parents aren't familiar with the term “pyloric stenosis,” they often do recognize that its main symptom, projectile vomiting, is something to worry about. While many babies have simple vomiting or spitting up, the baby with true projectile vomiting, which is often described as “going across the room,” should see her pediatrician.
Infants with this condition have an enlargement of their pylorus, the muscle that controls the outflow of food from the stomach into the intestines. As it continues to enlarge, formula or breastmilk is unable to get through and it is vomited back up. Although in many cases infants vomit after each feeding in the beginning, the vomiting sometimes occurs after only one or a few feedings, delaying the diagnosis.
Reflux or spitting up is a common condition that many babies have. For most of them, spitting up, even when it is frequent, doesn't cause anything more than a mess. However, if your baby is very fussy, especially when eating; if she is coughing and choking when she spits up; or if it doesn't seem that she is gaining weight as she should, reflux may be more serious.
Pyloric stenosis is more common in boys, seems to be genetic, peaks when infants are about three weeks old, and can be formally diagnosed with an ultrasound or upper GI test. The definitive treatment is surgery.
Umbilical Cord Problems
Parents usually get distressed when their baby's umbilical cord doesn't look quite right, and many don't like performing even basic cord care. The biggest problems occur when your baby's cord doesn't come off after three to four weeks, which can be caused by an umbilical granuloma, or if it gets infected. Keep in mind that a little odor or discharge can be normal. A cord is more likely to be infected if there is a lot of discharge or if the skin around the cord is red.
Umbilical hernias are also common and usually go away by the time your child is four to five years old. If your baby's cord is sticking out and seems painful, be sure to talk to your pediatrician.
