All your questions about newborn babies answered by a paediatrician

All your questions about newborn babies answered by a paediatrician
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How do I know if my child is getting enough breast milk? Why is my newborn’s skin peeling? How often should a newborn baby poop? Is it normal that my baby seems uncomfortable while pooping? Why does my baby keep sneezing? How warmly should I dress my baby?

These are some of the common questions the parents of newborn babies ask their paediatricians, so we asked BYY expert Dr Enrico Maraschin to answer them!

How warmly should I dress my newborn baby?

I always recommend that a baby should have one additional layer than what you are wearing. If you are in a T-shirt then baby should have a short vest with a long baby-gro. One’s natural instinct is to overwrap a baby and to keep it warm but a baby that is too hot is at an increased risk of “Sudden Infant Death”. Not sure how to tell if your baby is too hot or cold? Feeling your baby’s hands and feet will let you know if baby is cold or warm.

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Why is my baby twitching (like he is being startled) in his sleep?

A baby twitches in its sleep as part of normal sensory-motor development. When a baby twitches the brain is actually teaching your baby about its legs and arms and what baby can do with them. Amazing, isn’t it? This should only happen for a few seconds. If a baby has twitching that lasts longer than this, I would recommend that you video the movement on your cellphone so that you can show your healthcare professional – this is especially important if twitching is coupled with difficult breathing or turning blue.

Can I still wear perfume around my newborn?

The strong smell of perfume can cause irritation to your baby’s eyes, nose and chest. It is better not to use perfume, especially when breastfeeding, as a baby prefers mom’s natural scent. Some very strong perfumes may actually lead to allergic conjunctivitis and rhinitis, asthma, and eczema.

Why does my newborn keep sneezing & why does she seem congested?

In utero the nasal passage is filled with fluid but once a baby is born the nose has to adapt to the new environment. A baby produces mucus to protect the lining of the nose from dry air, pollution, allergies, viruses and bacteria. Adult noses do exactly the same, except we are able to blow our noses to clear the mucus.

Babies predominantly breathe through their nose and not through the mouth so keeping baby’s nose clear is important. If baby is congested you can administer normal saline drops in the nose to clear the congestion – sometimes a nasal aspirator is helpful to clear the nose if baby is very congested. In rare cases, your baby may have a congenital abnormality: if your baby is struggling to breathe then it is always a good idea to get baby seen by a healthcare provider.

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How do I know if my baby is getting enough breast milk?

Initially a baby who is rooting and looking for the breast may not be fully satisfied. Babies who sleep for long periods of time in the first couple of weeks (0 to 6 weeks) may actually have low blood sugar from a lack of milk. It is not that they are just ‘being good’. How often should a newborn baby feed? I recommend that a baby feed at least every three to four hours in the first six weeks.

If a baby is crying excessively and not able to settle after a feed then this may indicate that baby is hungry. Weekly weigh-ins are very important to ensure baby is getting enough milk and growing well. Baby should gain at least 120g a week. If baby is gaining less than this then it is a problem. It is really important for moms to know that their bodies are amazing machines. Generally a mother’s body will respond to her baby’s demand. Moms should ensure that they themselves are eating and drinking adequately to be able to produce the required milk.

How warmly should I dress my newborn baby 

My newborn’s skin is peeling. Why?

While baby is in the womb, the skin is being kept nice and moist by the amniotic fluid. Once baby is born the skin needs to adjust to the air and dry environment. Your baby’s skin may look dry and even begin to peel off while they adjust to the environment and build up their natural skin barrier function.

The use of olive oil or sunflower oil should be avoided because this disrupts the skin’s ability to develop its natural barrier and can also disrupt the skin’s natural flora and encourage the growth of certain yeasts. Instead, use a hypoallergenic emollient to help settle the dryness. If the dryness doesn’t improve then you may need baby to be checked by a healthcare practitioner to treat conditions like eczema.

How often should my new baby poop?

A baby who is breastfed may poo after each feed, so up to eight times a day – or as little as once every eight days. Both are normal. Babies who pass a stool infrequently and appear uncomfortable may need some help. Breastfed baby poo is bright yellow and runny. A bottle fed baby should poo at least once a day. Bottle fed baby’s poo is generally more firm and has a darker colour.

Why does my baby wriggle and moan when having a poo?

A baby doesn’t have good tummy muscles so passing a poo is actually hard work. Babies are also usually lying down so passing a stool in this position is difficult. You can help baby with passing winds and pooing by gently pressing the knees towards the chest. Passing a stool is involuntary for a baby so the process may cause some spasm and discomfort.

If the stools are thick and pasty or hard little balls then baby may be constipated and passing a stool is not easy. Constipation will cause pain and discomfort and should be addressed.

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Do I really have to sterilise the bottle after every use or can I use it for two feeds before washing it?

I recommend that parents sterilise bottles and teats up to six months of age. Thereafter, giving them a good wash in warm, soapy water is adequate. We wouldn’t drink from a dirty cup or eat off a dirty plate so applying this rule to your baby’s eating equipment is a good idea.

After 6 months of age, the teats and dummies should be washed after each use but only need to be sterilised once a day, until the baby is a year old. Please do not allow your expressed breastmilk or formula to stand for more than 2 hours before discarding the milk. This is to avoid bugs growing in the milk. Getting baby to drink from a cup or beaker, from the age of 6 months, may be messy in the beginning but these are far easier to wash.

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