Of all the things you expected to learn as a new mom, controlling your gag reflex probably wasn't at the top of the list. "When we dream of having a baby, it's all the lovely things we think of: the sweet-smelling skin, the cute clothes," says Rallie McAllister, M.D., a family physician in Lexington, Kentucky, and coauthor of The Mommy MD Guide to Your Baby's First Year.
"But then there's spit-up, poop, and all sorts of smelly yuck. It catches a lot of moms off guard." In other words, being grossed out by your little one now and then is perfectly normal. We'll help you handle the inevitable grodiness with grace.
What's normal All babies spit up sometimes. They have an immature lower esophageal sphincter, so the flap that separates the stomach from the esophagus doesn't always close completely. "Babies don't hold their food down like adults do," says Dr. McAllister. It's alarming when your angel seems to upchuck half a feeding, but it's probably nothing to worry about. "As long as your baby is comfortable and happy, that's just part of the process -- an occupational hazard of being a mother."
What to do Keep a supply of burp cloths on hand (and shoulder) for quick clean-ups, and invest in some bibs that will shield her rompers. At bath time, take extra care to wash the folds around her neck, because spit-up stuck in crevices can irritate her skin (and cause a stink). Positioning your baby at a 30-degree angle during feedings and frequently burping her can help her keep food down, says Vinita Seru, M.D., a pediatrician with North Seattle Pediatrics. The good news: Most babies start to spew less frequently at around 6 months, as their GI system matures.
When to call the doc If Baby cries when she spits up or she isn't gaining weight, talk to your pediatrician. The two most common culprits are gastroesophageal reflux (treatable with infant-friendly heartburn medication) or a food allergy. If it is an allergy, you'll need to revisit what she's eating or, if you're breastfeeding, what you're eating. Among the most common triggers: seafood, dairy, coffee, alcohol, and hot peppers. Try eliminating them one at a time for seven to ten days, and see if you notice a difference. Or if your little one is bottle-feeding, ask your doctor about switching formulas. More worrisome is when Baby's not only spitting up but projectile vomiting. If this happens (even once), she could have pyloric stenosis, an obstruction of the lower part of the stomach that affects 3 of every 1,000 babies. Call a doc!
What's normal For the first few months, your baby's diaper is like a box of chocolates -- you never know what you're gonna get. A newborn's poop changes from black tar-like meconium to seedy mustard stools to brown or greenish mush, depending on what he's eating and how his intestines are processing it. "Moms and dads are, like, 'Oh my gosh, what is this?'?" laughs Erika Landau, M.D., assistant clinical professor of pediatrics at Mount Sinai School of Medicine, in New York City, and coauthor of The Essential Guide to Baby's First Year. "It's normal newborn stool!" And it makes an appearance at almost every diaper change. Food travels through your baby fairly quickly, especially if he is breastfeeding, because breast milk is designed to be super easy to digest.
What to do After a bowel movement, you know to clean the area thoroughly with wipes (front to back for girls). Then play a game of peekaboo before you put on a new dipe to allow Baby's skin to dry. (If you have a boy, cover his crotch with a cloth so you don't get a sprinkle!) "Fungus and yeast grow in dark, damp places like the diaper area," Dr. McAllister says. Apply cream to prevent diaper rash.
When to call the doc Because your average newborn is a poop machine, diarrhea can be hard to identify. Watch for liquidy stools that soak through the diaper five or six times a day and that smell, um, horrible. The odor is an indication that stool is moving through the digestive tract too fast for nutrients to be absorbed. If your tot cries or seems in pain when he poops, and if it resembles rabbit pellets, he's probably constipated. Either condition warrants a call to the doc, as does blood in Baby's stool.
Snot and Eye Junk
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What's normal When babies get mucusy, a standard-issue cold is usually to blame -- they average about six a year. However, a constant runny nose might signal allergies to smoke, dust, mold, a pet, or even formula, which can sometimes be treated with medication. Whatever the cause, it makes breathing and eating tough. (Until 6 months, babies breathe almost entirely through their nose.)
What to do Your little guy doesn't know how to blow his nose, so you'll have to extract the boogers. First, squirt a drop of saline solution into each nostril to loosen the mucus.
Then take a bulb syringe -- that small rubber gizmo that probably came with nail clippers -- and squeeze the bulb to let the air out. Insert the tip into your baby's nostril, and slowly release the compressed bulb (watch a tutorial at americanbaby.com/cold-video).
As the bulb expands, it will suck the mucus out. Repeat until the nostril is all or mostly clear and then move on to the other side. Warning: Babies aren't big on this method. Enlist help.
When to call the doc Normal mucus is clear, but green or yellow mucus can sometimes (though not always) be a sign of trouble. In addition to that, watch for other signs of illness, such as blood in the mucus, listlessness, crankiness, or a fever over 100.3° F in an infant younger than 3 months. For older tots, behavior is more important than the number on the thermometer. If your baby has a temp of 102°F but is active, nursing, and wetting his diapers at a normal rate, you don't necessarily need to alert your ped. If he has a temp of 101°F but is irritable, it's worth a call. Also, keep an eye on your sweetie's breathing, which can become labored. "If his belly starts to go up and down very fast, and you can see the muscles straining between the ribs, he is working too hard to breathe," says Dr. Landau. Call the doc right away.
What's normal When white goop or yellow crusties obscure one of your baby's peepers, it may just mean her eye is doing its job. Any irritant -- an errant eyelash, a scratch -- will make the eye produce extra mucus to soothe it or wash out the source of the bother. If the goop goes away on its own in a day or two, no need to worry.
What to do To clear up crustiness, gently wipe it away with a damp, warm cloth. Try eliminating potential allergens like irritating shampoos or a tummy-time blanket that sheds. Avoid cigarette smoke, which can bother Baby's eyes -- and far worse.
When to call the doc If the gunk doesn't go away on its own or if your baby's eyes are bloodshot, she may have conjunctivitis (pink eye), which you can treat with prescription eye drops. If the goop doesn't subside even after you've treated it for several days, "often the eye discharge is caused by a blocked tear duct," Dr. Seru says. "It's not infectious and resolves on its own by age 1 in 98 percent of babies."
Tips on How to Deal
"I think I'm gonna be sick..."
Skeeved by what's dripping out of your baby's nose or diaper? It doesn't make you a bad mom! Try these tricks to quell the queasies.
Outsource. "Switch off with your partner," says Dr. McAllister. If you can handle boogers but can't do eye drops, divide and conquer the dirtier jobs.
Pretend you're on Grey's. Wear a disposable germ mask (available at drugstores, McDreamy not included) when dealing with a diaper blowout.
Breathe through your nose. This may be hard to believe, but breathing through your mouth actually triggers a gag reflex more quickly.
Suck on some salt. If you're worried you'll gag, dip a moist finger in table salt and dab it on the tip of your tongue. Weird, but it works!
Originally published in the May 2013 issue of American Baby magazine.
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