Where your own health is concerned, you rarely let a cold put a crimp in your schedule and you probably trudge to the doc's office only if you're suffering. So why has parenting an infant turned you into a raging hypochondriac? Suddenly every weird poop requires you to anxiously inquire with the doctor, and each sniffle seems like an early sign of bubonic plague. If you're scared stiff that your tot will get sick, you're not a wuss -- and you're definitely not alone. "With the first baby, every bump or rash is a mini crisis," says Victoria Rogers McEvoy, M.D., author of The 24/7 Baby Doctor. "Once you gain perspective and realize that most things pass, you can relax and stop obsessing."
Of course, perspective is hard to come by when you're caring for a fragile peanut, so remember this: Most of the time, the conditions you're panicking about (those police-siren cries! that eye goop!) are completely normal. Keep calm with our expert advice on what you can ignore -- and when to dial the doc.
WHY IT'S OKAY If this is only the first or second night she's been fussy, the more likely culprit is gas, which stretches out your baby's Lilliputian GI tract as it wends its way through her intestines. If, however, your infant turns out to be super-agitated every late afternoon and evening, colic is certainly a possibility. It's not as dire as you may think, though: Colicky babies seem uncomfortable, but they aren't typically in significant pain, and they can be soothed, at least for a while, with a calming technique such as swaddling, swinging, rocking, or heading out for a drive, says Katy Cahill, M.D., a pediatrician with University of Wisconsin Health, in Madison.
WHEN TO SEE THE DOCTOR If you've got a howler on your hands, check in with your pediatrician to rule out physical causes that are sometimes overlooked, such as an ear infection or a corneal abrasion. And if you can't soothe your infant
for even a short spell, her cries could indicate a problem in the intestinal tract, an infection, or an injury. "It's usually possible to briefly console a colicky baby," Dr. Cahill says. "It's the inconsolable babies that worry me."
WHY IT'S OKAY Spit-up is unnerving (and icky), but more than half of all babies have reflux in the first three months, and it usually bothers their parents much more than it does them. Part of the problem: The esophageal sphincter, a flap that closes over the top of the stomach, is still developing, so a little backflow is almost inevitable. Plus, babies "suck like maniacs, and milk is flying down into their stomach faster than they're really built for," says Ken Haller, M.D., an associate professor of pediatrics at St. Louis University School of Medicine, in Missouri. "It's very easy for newborns in particular to overfeed -- then they spit up." You can slow things down with a burping session every 2 ounces; the pause gives your baby a moment to realize, "I'm full now."
WHEN TO SEE THE DOCTOR If the reflux is so severe that your baby doesn't appear to be gaining weight, your doctor might prescribe an infant-friendly antacid such as Zantac or Prilosec. If your tot seems to be projectile vomiting or throwing up virtually everything at every feeding, pyloric stenosis, a blockage that prevents the stomach contents from emptying into the intestine, could be to blame. The condition is rare (it occurs in only 3 out of 1,000 babies), but it may be worth a look.
WHY IT'S OKAY Weird colors and consistencies as well as fast and frequent poos are par for the course. "Babies have an active gastro-colic reflex, so it's normal for them to make a bowel movement every time you feed them in the first weeks," Dr. Haller says. "The consistency can be soft clay to scrambled eggs, and the color yellow, green, or brown."
WHEN TO SEE THE DOCTOR Diarrhea, which indicates sickness, can be hard to distinguish from normal poop, so watch for other symptoms of a bug: fever, unusual fussiness, vomiting, dehydration, and poor eating. If eight to ten hours pass without a wet diaper, she might be dehydrated -- a serious side effect of diarrhea. As for colors, "white, red, and black are the shades of poop we most worry about," says American Baby advisor Laura Jana, M.D., coauthor of Heading Home With Your Newborn. (White poop can indicate a digestive problem; red or black suggests blood in your baby's stool, a potential sign of an allergy or other issue.)
WHY IT'S OKAY It's called a common cold for a reason. With more than 200 cold-causing viruses out there, your baby will likely encounter between eight and ten of them before his second birthday. The symptoms (cough, runny nose, sore throat, mild fever) can drag on for ten days. He may look and sound worse than he feels, however; babies breathe mostly through their nose until about 6 months, which means that when those teeny nasal passages get congested, your infant will sound terrible (and may refuse to eat). Forget over-the-counter cold medications -- they can be dangerous for babies. Instead, to help him feel better, spritz one or two drops of saline solution in each nostril and use a bulb syringe to suck out the loosened mucus. (Squeeze the bulb, insert the tip gently in baby's nose, then let go.)
WHEN TO SEE THE DOCTOR On rare occasions, what looks like a cold is actually respiratory syncytial virus (RSV), which can lead to serious problems such as pneumonia. If you notice flared nostrils, deep chest inhalations, or rapid breathing that doesn't let up -- signs your baby is struggling for air -- call your pediatrician ASAP.
WHY IT'S OKAY "Babies get rashes all the time -- many different ones," explains Dr. McEvoy. "Initially you can handle most of them at home." To treat cradle cap, massage warm baby oil into your infant's scalp, then brush away the flakes. Most other rashes, like baby acne and heat rash, will wane on their own without assistance from you; use mild soap at bathtime and keep his skin cool and dry.
WHEN TO SEE THE DOCTOR If a rash lingers, looks like purplish pinpoints, has blisters, or makes your baby miserable, talk to your doc. "Call for help when what you're doing is not working or is getting worse," Dr. McEvoy says. A diaper rash that doesn't improve may be a yeast infection requiring an antifungal cream. OTC lotions can sometimes treat eczema, a chronic condition marked by red patches of scaly, itchy skin, but you'll first want your doctor to diagnose the problem. If your tot has blisters that are tiny and yellowish, or white and fluid-filled, it's often erythema toxicum, a harmless rash that usually disappears by the time baby is a week old. Sometimes, though, blisters can indicate something more serious, like herpes.
A fever is a red flag in the first few months because it can indicate serious problems, anything from an infection to pneumonia. Until your baby is 12 weeks, call the pediatrician if he spikes a temperature above 100.4 degrees F; once he's 3 to 6 months, a fever of 101 degrees F or higher deserves a call to the doc; with older babies, 103 degrees F or above causes concern. To find out if your little one is feverish, take his temp with a digital rectal thermometer, which provides the most accurate reading. It's scary, yes, but doable. Ask your M.D. or nurse for a tutorial at your baby's first checkup, but here's a quick how-to:
-- Apply Vaseline or lubricant (like K-Y Jelly) to the end of the thermometer.
-- Insert the tip 1/2 to 1 inch (at least the length of a pencil eraser) into your baby's anus, and hold until the thermometer beeps.
-- Watch out! "Taking a baby's temperature often causes him to poop," warns Katy Cahill, M.D.
Originally published in American Baby magazine.
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