Common ailments
Spending time getting to know your new baby is a very exciting time. It can also be
nerve-racking, especially for first-time parents.
There are some common conditions that your baby may experience. Most are
nothing to worry too much about, but knowing what to expect can help you look after
you baby and know when to seek medical attention.
Loose stools
Most babies have occasional loose stools (poo), and breastfed babies have looser
stools than formula-fed babies. Diarrhoea is when your baby is frequently passing
unformed, watery stools.
Sticky umbilicus
Once the umbilical stump detaches, the belly button underneath may become a little
sticky with a spot of blood around it. You can clean with cool boiled water and a fresh
piece of cotton wool. Try to stop your baby’s nappy rubbing on it if possible.
Sticky eyes
Sticky eyes are quite common in babies and are easily treated. Clean the eyes from
the nose outward with cotton wool dipped in cooled boiled water, not too wet. Make
sure you use a separate piece of cotton wool for each eye. Speak to your health
visitor or GP if you have any concerns about your baby’s eyes.
Enlarged breasts
Some babies develop what appear to be breasts. This is because of hormone levels
in their milk, and they should go down in time. If you are worried, mention it to your
health visitor or GP.
Rashes
It's normal for babies to develop skin rashes from as early as a few days old, as their
sensitive skin adapts to a different environment. Most rashes are harmless and go
away on their own. However, if your baby has developed a rash and seems unwell,
or if you're worried, see your GP to find out the cause and for any necessary
treatment.
Cradle cap
Cradle cap is the yellowish, greasy scaly patches that sometimes appear on the
scalp of young babies. It's a common, harmless condition that does not usually itch
or cause discomfort to the baby.
It usually clears up on its own. Gently washing your baby's hair and scalp can help
prevent a build-up of scales, and massaging baby oil or natural oil – such as almond
or olive oil – into their scalp at night can help loosen the crust. It's important not to
pick at the scales as this may cause an infection, so use a soft bristled hairbrush.
Nappy rash
Most babies get nappy rash at some time in the first 18 months. Nappy rash can be
caused by:
Prolonged contact with urine (wee) or stools (poo)
Sensitive skin
Rubbing or chafing
Soap, detergent or bubble bath
Baby wipes
Diarrhoea or other illness.
There may be red patches on your baby’s bottom, or the whole area may be red.
The skin may look sore and feel hot to touch, and there may be spots, pimples or
blisters.
The best way to deal with nappy rash is to try to prevent your baby getting it in the
first place:
Change wet or soiled nappies as soon as possible. Young babies need
changing as many as 10 or 12 times a day; older babies at least 6 to 8 times.
Clean the whole nappy area thoroughly, wiping from front to back. Use plain
water or baby wipes.
Lie your baby on a towel and leave the nappy off for as long and as often as
you can in order to let fresh air get to the skin.
Use a barrier cream, such as zinc and castor oil, and rub it in well.
If your baby gets nappy rash you can treat it with a nappy rash cream. Ask your
health visitor or pharmacist to recommend one.
If the rash doesn’t go away or your baby develops a persistent bright red, moist rash
with white or red pimples, which spreads to the folds of the skin, they may have a
thrush infection. You’ll need to use an anti-fungal cream, available either from the
pharmacist or on prescription from your GP. Ask your pharmacist or health visitor for
advice.
Milia (milk spots)
About half of all newborns will develop small white spots, called milia, on their face.
These are just blocked pores and usually clear within the first four weeks of life.
Baby ‘acne’
Pimples sometimes develop on a baby's cheeks and nose. These tend to get worse
before clearing up completely after around six weeks.
Oral thrush
Symptoms can include one or more white spots or patches in and around the baby's
mouth. These may look yellow or cream-coloured, like curd or cottage cheese. They
can also join together to make larger plaques.
You may see patches on your baby's gums, on the roof of their mouth or inside their
cheeks. The patches may not seem to bother your baby. But if they are sore, your
baby may be reluctant to feed.
Other signs and symptoms of oral thrush in babies include a whitish sheen to their
saliva, fussiness feeding or refusing the breast, clicking sounds during feeding, poor
weight gain and nappy rash. Some babies may dribble more saliva than normal if
they have an oral thrush infection.
Most cases clear up on their own. Your GP or health visitor may prescribe an antifungal treatment called Nystatin which is a liquid applied directly onto the thrush
using a dropper. Most babies accept this treatment without any problems.
Colds and snuffly nose
Colds are common and most frequently caused by a variety of viruses. Gradually,
children build up immunity and get fewer colds. Most colds get better in five to seven
days.
If your child has a cold, increase the amount of fluid they drink. Encourage the whole
family to wash their hands regularly to help stop the cold spreading. Because colds
are caused by viruses, not bacteria, antibiotics don’t help.
A warm, moist atmosphere can ease breathing if your child has a blocked nose.
Take them into the bathroom and run a hot bath or shower or use a vaporiser to
humidify the air.
Saline nose drops can help loosen dried nasal secretions and relieve a stuffy nose.
Ask your pharmacist, GP or health visitor about them.
Fever
A fever is a temperature above 38˚C and is usually caused by a virus which the body
is dealing with. For children under four weeks old, use a digital thermometer under
the armpit to take their temperature. Over four weeks old, use a digital ear
thermometer.
Ensure the baby is dressed appropriately for the room; make sure the environment
itself is not too warm. Cold sponging a baby to treat a fever is not effective and only
causes distress.
Medicines to treat a fever can only be given over 8 weeks of age – Paracetamol at 8
weeks of age or at 3 months – Ibuprofen. If giving any medication before 12 weeks
please check with a health professional
Follow the dosing instructions on the box for the amount and how often it can be
given, use the syringe that comes with the medicine, just wash it out and use again.
Own brands work just as well as named brands.
You do not need to give paracetamol/ibuprofen before Immunisations – it may even
reduce the effectiveness of the immunisations. Over 8 weeks of age, paracetamol
can be given if your baby becomes very irritable or develops a temperature over
38˚c, please check with your practice nurse for advice after immunisation.
Diarrhoea and vomiting
Infections can cause diarrhoea with or without vomiting. This is called gastroenteritis
(a stomach bug). Stomach bugs are more common in formula-fed than breastfed
babies.
Contact your GP or health visitor urgently for advice if your child has passed six or
more diarrhoeal stools in the past 24 hours or if your child has vomited three times or
more in the past 24 hours.
If other family members or people your baby comes into contact with have a stomach
bug, ask them to wash their hands frequently using liquid soap in warm running
water and drying their hands carefully. Keep toilets clean and wash towels
frequently. With formula-fed babies, make sure bottles are sterilised thoroughly.
Babies are more at risk of becoming dehydrated due to vomiting or diarrhoea than
older children. Symptoms of dehydration include lethargy or irritability; a dry mouth;
loose, pale or mottled skin; cold hands and feet; and sunken eyes and fontanelle. A
dehydrated baby may pass very little urine and may feed poorly, but it may be
difficult to tell how much urine they are passing when they have diarrhoea.
In general, for mild diarrhoea, give extra fluids. Use cooled boiled water. Don’t stop
breastfeeding. Give the extra fluid in addition to breast or formula milk.
For more severe diarrhoea, or diarrhoea with vomiting, don’t stop breastfeeding. Get
expert advice. Speak to your GP - they may suggest oral rehydration fluids. If you
are formula feeding, stop. Instead, give small amounts of oral rehydration fluids
every 10 minutes or so. Keep doing this even if your baby is still vomiting. Most of
the fluid will stay in, even if it doesn’t seem that way! Restart normal formula feeds
after three to four hours. Your GP will give you advice.
Constipation
For babies with constipation who have not yet been weaned, give them extra water
between their normal feeds. However, do not try to dilute formula milk, continue to
make it as directed bon the packet.
You can try carefully massaging your baby’s tummy and cycling their legs to
stimulate their bowels.
Reflux
Reflux is similar to heartburn and is caused by a back-flow of milk leaving the
stomach and entering the food pipe. It will be partially digested and slightly acidic. It
happens because the valve at the top of the stomach is under developed.
Symptoms include crying during feeds or refusing to feed, arching their backs,
irritability, coughing at night, weight loss or poor weight gain. Babies may vomit
varying amounts.
When to get urgent medical help
The following symptoms in a baby should always be treated as serious:
An unusual high-pitched, weak or continuous cry
Lack of responsiveness, reduction in activity or increased floppiness
Bulging fontanelle (the soft spot on a baby's head)
Neck stiffness
Not drinking for more than eight hours (taking solid food is not as important)
Temperature of over 38°C for a baby less than three months old, or over 39°C
for a baby aged three to six months old
A high temperature when coupled with cold feet and hands or quietness and
listlessness
Fits, convulsions or seizures
Turning blue, very pale, mottled or ashen
Difficulty breathing, fast breathing, grunting while breathing, or if your child
is working hard to breathe, for example sucking their stomach in under their
ribs
Your baby is unusually drowsy, hard to wake up or doesn’t seem to know you
Your baby child is unable to stay awake even when you wake them
A spotty, purple-red rash anywhere on the body
Repeated vomiting or bile-stained (green) vomiting.
Call an ambulance for your child if they:
Stop breathing
Are struggling for breath (you may notice a sucking in under the ribcage)
Are unconscious or seem unaware of what's going on
Won’t wake up
Have a fit for the first time, even if they seem to recover.
Take your child to A&E if they have:
A fever and are persistently lethargic despite taking paracetamol or ibuprofen
Difficulty breathing (breathing fast or panting, or very wheezy)
Severe abdominal pain
A cut that won't stop bleeding or is gaping open
A leg or arm injury that means they can’t use the limb
Swallowed a poison or tablets.