Parenting: Tricky new baby questions answered

Babies can sometimes appear fragile.

Janine Gard is a diploma-qualified birth educator (2005) and founder of Bellies to Babies antenatal and postnatal classes. She has helped more than 3700 parents prepare themselves mentally, emotionally and physically for their journey to parenthood and loves what she does. This week Janine answers some common questions new parents may have.

Many new parents are filled with worry when a baby enters their life.

After all, infants look fragile and helpless. And aside from those shrieking cries, newborns can't communicate their specific needs in obvious ways. So it's natural to have concerns when caring for them. Let's have a look at some of these.

My newborn's eyes sometimes crossed, should I be worried?

It's normal for babies to intermittently cross their eyes, even at 6 months, it takes a wee while for the muscles behind their eyes to strengthen. But if your baby's eyes are always crossed, tell your LMC or GP.

Is it normal for a baby's breasts and genitals to appear swollen?

Both girls and boys can have swollen breasts that might express some milk - due to in utero exposure to hormones. For this reason, a baby girl's labia may also swell, and she might have a little bloody discharge. This is normal as long as it's just a tiny spot and doesn't persist. On the other hand, swelling around a boy's genital area may be due to a hydrocele. This is a fluid-filled sac around the testes, so it makes the scrotum look enlarged and usually disappears within their first year without any treatment.

Are there special considerations for girls versus boys when changing nappies?

Always wipe from front to back when changing a girl. Girls are more prone to UTIs (urinary tract infections) so it is important that you avoid getting any bacteria into the vagina. Opt for a sensitive fragrance-free wipe when cleaning a little girl and limit the use of soap as it can irritate the vagina. You will need to clean the labia as well as the creases and folds on your baby's legs.

Boys have an uncanny ability to wee as soon as the nappy is off and their penis hits the freedom of the air. So, be prepared with a towel or extra nappy on hand to catch the wee (and prevent it from going over you). Make sure you position the penis so that it is down before you put the nappy on. This will ensure that he stays drier.

Are a baby's bowel movements similar to what an adult experiences?

Not at all. In fact, your baby's first poop will be meconium, a tar-like, blackish-green substance that you'll see for a couple of days. After the meconium runs its course, greenish-brown transitional stools follow; by the fourth or fifth day, breastfed babies pass yellowish, seedy poop, while formula-fed infants' stool is denser and ranges in colour from yellow to brown-green.

Expect variation in how often your infant has bowel movements. A formula-fed infant may poop three or four times a day, while a breastfed infant may go after every feeding or as infrequently as once a week.

My newborn sometimes throws her arms out from her sides. Is she okay?

This is the Moro, or startle reflex, and it usually occurs when a baby is surprised by a loud noise or sudden movement, If you never see it, tell your GP because your baby could have a hearing, nerve, or muscle problem.

The roof of my daughter's mouth is covered with small white bumps. What are they?

Don't stress - they're just harmless little cysts, known as Epstein's pearls, that will disappear as your baby gets older. However, if you spot big, blotchy white areas growing in your child's mouth (even on her tongue), this could be thrush - a type of yeast infection - check with your GP if you have any concerns.

My baby's skin has a yellow hue. Should I be concerned?

Jaundice is a yellow discolouration of the skin and the whites of the eyes that occurs in many babies. It's caused by bilirubin, a substance that accumulates in the blood. As the baby's liver matures - usually within a week or two of birth - the yellowish tone of his skin should fade away.

My newborn's head is misshapen, is this normal?

A baby's skull is made up of five head bones and two soft spots in between called fontanels. It's built this way to help their head pass through the vagina, which is why some newborns wind up with cone-shaped heads. But don't fret, their skull will round out soon enough.

Cord care

The umbilical cord stump should fall off within the first week of your little one's life; until then, make sure to keep it clean and dry. Give your GP or LMC a call if you notice foul-smelling discharge or the site still looks open and raw two weeks after the cord has fallen off.

Crying

There's no doubt that newborns cry - it's how they communicate. Whether you have a calm baby or a fussy one, you'll start to get used to all the variations of those little whimpers and wails this first month. In fact, crying can be a sign a baby is healthy. But what if she seems to cry all the time?

Some babies just cry more than others. Studies show that 80 to 90 per cent of babies have daily crying sessions from 15 minutes to an hour that are not easily explained. Sometimes these sessions are predictable - in the evening or after a busy day out of the house, for example.

Make sure they aren't hungry, don't need a nappy change, and haven't had something uncomfortable happen, like a thread wrapped around a toe or a scratchy tag bothering their neck. If all that is in check, help them through it the best you can by rocking, walking, singing or cuddling them.

It may take several tries to help them calm down. But if you feel yourself losing patience or are just plain worn out, it's okay to put them down somewhere safe like their crib for a few minutes. They may even surprise you and drift off to sleep by themselves.

Some parents wonder if their baby has colic

A colicky baby will often have symptoms beyond simply crying — balled-up fists, tightly closed or wide-open eyes, knees pulled up to her chest, flailing limbs, gas and short bouts of held breath are all common.

Doctors usually diagnose colic using "the rule of threes" — three hours of crying, three days a week, lasting for at least three weeks. About one in five newborns has crying spells that are severe enough to be called colic. Though there are strategies for soothing a baby's cries, including those of colicky infants, although, sometimes nothing seems to work. The best thing you can do to get through colic is to try to stay calm and take turns with a partner or caregiver in giving your baby attention.

While colic usually starts around week two or three of a baby's life, it most often peaks in severity around week six and may continue for several months. Baby massage can be great at helping calm (both yourself and your baby) and help pass the trapped wind.

Remember that you know your baby best. If you are concerned about any aspect of your baby's health, consult your GP, Well Child provider, or call Healthline on 0800 611 116 for more advice. If it is an emergency, do not hesitate to call 111 for an ambulance, or take your child to the emergency department of your nearest hospital.

■ Bellies to Babies Antenatal & Postnatal Classes, baby massage courses and baby and infant first aid courses, 2087 Pakowhai Rd, Hawke's Bay, 022 637 0624. https://www.hbantenatal-classes.co.nz/

Medical disclaimer: This page is for educational and informational purposes only and may not be construed as medical advice. The information is not intended to replace medical advice offered by physicians.