Newborn health guide

Most babies are well and don’t need much input from healthcare professionals, but there are some illnesses and conditions that newborns (and parents) may have to contend with.

Note: This is not an extensive list or diagnostic tool. If at any time you are worried about your baby, trust your instinct and call your health provider or 111, or, if you feel it’s urgent, you can always take your baby to A&E or call 999.

Common newborn health issues:

Jaundice

Jaundice is common in newborn babies and often what we describe as physiological - meaning it’s part of the natural workings of the body. Jaundice occurs due to a build-up of bilirubin (a yellow substance) that is produced when red blood cells are broken down. This process is normal for babies as they have more red blood cells in the womb than they need ‘outside’.

The symptoms normally develop around two days, or more, after birth. Mild jaundice may not need treatment and once diagnosed should take around two weeks to get better. Jaundice is usually picked up in a routine check by your doctor or midwife. Premature babies are more likely to get jaundice when compared to term infants. Only 1 in 20 babies reach bilirubin levels high enough requiring treatment.

Signs and symptoms of mild jaundice:

• Yellowing of the skin and white of the eyes
• This may be less obvious in babies with darker skin – check the palms of the hands and soles of the feet
• Yellow or dark urine (should be pale)
• Pale-coloured poo (should be orange/yellow)

If symptoms develop after you have been discharged from maternity services, you can still call your midwife or GP. It’s important to get an assessment as soon as possible.

More severe jaundice

Contact your GP or midwife immediately if…

• The yellowing and above symptoms get worse
• Your baby is reluctant or refusing feeds
• Your baby is drowsy

Treatment:

After assessment by your midwife or GP, there may be a need for your baby to receive treatment in hospital. Although some trusts are now able to offer home treatment due to some fantastic technology. The two treatments available are:

• Phototherapy – a lamp is used to supply a special type of light on your baby’s skin. This changes the bilirubin into a form that can more easily be broken down by the liver.
• Exchange Transfusion – this is rare and only recommended in severe cases. The baby’s blood is replaced by matched donor blood. Most babies respond well to this and return home within a few days.

Complications:

If your baby needs treatment and does not receive it, there is a risk of a more serious condition, known as kernicterus, developing – which could lead to brain damage. This is very rare in the UK and jaundice is usually picked up and treated very quickly without further complications.

Colic

Although awful for you and your baby, colic is not a serious condition and often self-resolves by around 12 weeks. It’s a bit of an umbrella term used for prolonged crying, most commonly in the evening. It’s thought that around 20-25% of newborns experience some degree of colic. It can start in the first few weeks and usually peaks at around six to eight weeks.

The cause is largely unknown, which can be very difficult for new parents. Experts do have different opinions on the causes, many believing an immature gut and trapped wind are to blame. Others believe it’s due to the development and exposure to so many stimuli. The womb remains a predictable, dark place, but life outside of the womb differs greatly.

Signs include:

• Frequent, prolonged, intense crying in a healthy baby – for no obvious reason
• Fussiness
• Red face
• Drawing knees up towards chest and clenched fists
• Flatulence

If you think your baby has colic, speak to your GP, midwife or health visitor and discuss ideas on how to help calm your baby. As we still don’t know the exact cause of colic you may want to follow their advice and see what works or helps. Unfortunately, sometimes nothing seems to help and it’s a case of riding the storm – a big storm but it does come to an end eventually. Things to try:

• If you are breastfeeding, be conscious of what you are eating as too much spicy food can contribute/make it worse
• If bottle feeding, control how quickly baby takes in the milk and introduce breaks, if necessary, to slow the pace
• Put your baby in a sling and walk around or sing to them
• Sit baby up after feeds and/or during feeds to allow baby to burp
• Gently rub and pat baby’s back whilst they are sitting up. Don’t pat excessively or too firmly; gentle, circular motions/sweeping upwards from lower to upper back
• Take baby for a walk or short ride in the car
• Try laying baby across your chest/shoulder and gently rub their back. This can be soothing and help to bring up wind (have a muslin or similar ready on your shoulder to catch regurgitated milk)
• Rock and change baby’s positions to see if these help to soothe them

As mentioned, despite trying all the above, you may be unlucky and find nothing works! It can be equally distressing for you and make you feel helpless. You’re doing an amazing job. Try to get breaks by asking your partner or friends and family to chip in with working through the episodes of colic. It can be physically and mentally exhausting, but it doesn’t last forever.

Reflux

It’s common for newborns to have some regurgitation after feeds. This is where small amounts of milk come back up after a feed. Holding your baby more upright for as long as possible after feeding can prevent milk from coming back up, alongside considering different feeding positions. In most cases, it will settle but some babies do have more severe reflux. Some of the signs are:

• Bringing up sick during or just after feeds regularly
• Hiccups and coughing
• Burping, swallowing or gulping after feeds
• Unsettled and crying

If ever you’re unsure always speak to your midwife or health visitor about any of these symptoms.

When to call 111 or ask for an urgent GP appointment:

• ‘Projectile’ vomiting (the vomit comes out forcibly)
• You’re concerned they are becoming dehydrated
• Their vomit is coloured with blood, yellow or green
• Has a swollen, tender tummy
• Refuses to feed
• Is repeatedly sick and can’t keep anything down
• Has continuous, distressed crying

Cradle cap

A common but harmless skin condition with the medical name, seborrheic dermatitis. It’s usually found on the scalp but can affect the face too. It’s not the most pleasant looking but isn’t painful or infectious. Usually cradle cap causes crusty, thick white or yellow scales that are not itchy. In most cases it will clear up within 12 months.

Treatment:

• You don’t necessarily need to treat it; cradle cap can be left alone and will often self-resolve
• Lightly massage a natural oil (avoid olive oil) onto your baby’s scalp to help soften it. You can use a very soft and gentle brush after doing so if you wish
• Don’t pick the crusts! Although tempting for some this can be painful for your baby and cause broken skin, increasing the chance of infection