Babies do not come with instructions attached and no-one can ever prepare parents for the major lifestyle change that a baby brings along with it. However, with good planning and some knowledge about the common ailments that afflict most babies, caring for a newborn child can be a fulfilling and rewarding experience. Here are a few tips…

Feeding

The World Health Organisation recommends that a baby should be breast-fed for at least the first two months of life. During the first few days of milk production, the body produces a substance called colostrum which contains important antibodies not present in formula milk. This substance is very beneficial to the baby and helps to protect him or her from infection. It is important to use both breasts during each feed. When the baby stimulates the nipple by suckling, a chemical called oxytocin is produced in the mother’s body. This allows milk to be let down through the nipple and helps milk production for future breastfeeding.

A baby on formula milk receives almost the same benefits as a breast-fed baby

There may be mothers who, because of medical or other reasons, are not able to breast-feed. These mothers should never feel guilty about not breast-feeding their child. Most modern formula milks are designed to imitate human breast-milk as much as possible, so that a baby on formula milk receives almost the same benefits as a breast-fed baby.

Sleep

Never allow a baby to sleep in your bed. Babies should be put to sleep in a cot and always on his or her back. The bars on the sides of the cot should not be more than 7cm apart and the rails should be at least 50cm above the mattress. A pillow should not be used before the baby is six months old.

Baby poop

In the first day or two of life, the baby’s stools are usually dark and tarry. This is called meconium. As the baby feeds (breast milk or formula), stools tend to have the colour of mustard and are soft in consistency. Blood in the stool is never normal. If this is seen, the doctor should be called right away. The frequency of passing stool varies from baby to baby. Some soil their nappy after every feed, others pass stool every two days. This is quite normal as long as the stool is yellowish and soft.

Reflux

A baby’s oesophageal muscles are not yet developed as an adult’s. This causes liquids to reflux (brought back up from the stomach to the mouth) more easily. Reflux can lead to discomfort after feeds, causing crying and distress, as well as spitting out, vomiting or even aspirating feedings. Holding the baby upright for at least 20 minutes after feeding helps prevent the baby from refluxing. If crying and reflux persist after each feed, the baby should be seen by a doctor

Vaccination

At the age of six weeks, the baby is ready to receive the first vaccination which protects against five or six different diseases. Vaccination is the safest and most effective way of preventing a number of diseases. The National Immunisation Schedule provides a number of vaccinations free of charge to babies from the age of six weeks. The vaccination programme extends up to the age of 16 years. Further information may be obtained from the Immunisation Clinic in every health centre.

Starting solids

Solid foods should be held off until the baby is six months of age. According to recent studies, this has been shown to significantly reduce obesity in children. Weaning should start with spoonfuls of rice cereal (never place in the bottle as this can be a choking risk) and stepped up to one new food group each week. This way, any allergic reactions to specific food types can be pinpointed easily.

Sniffles

Babies are primarily nose-breathers. Their airway muscles are not as strong or developed as an adult’s are so they are not able to cough or sneeze as efficiently when their airways are clogged with mucous. If the baby sounds congested or becomes distressed while feeding, saline solution drops or spray may be used to clear both nostrils up to four times a day. The saline preparations are available over-the-counter.

Newborn fever

Many parents are unaware of what is considered an actual fever in a newborn. Any temperature equal to or greater than 38 degrees Celsius is considered a fever in a baby less than two months old, and he or she should be seen by a doctor immediately. Newborn babies often do not show the typical symptoms that adults do when they are ill. Fever is one of the few signs of infection in babies less than two months old and may even indicate bacteria present in the blood, urine or in the layers covering the brain.

Where to find advice

It is very important to have a family doctor who can give advice and guidance on how to care for a newborn baby, as well as manage any ailments that may crop up. Many parents opt to have a paediatrician check the baby’s growth and development periodically.

The Primary Child Health Unit within Primary Health Care offers routine visits by appointment for babies from the age of six weeks at the Well Baby Clinics available in most health centres.

Parents are invited to bring their baby for the first visit which is co-ordinated with the Immunisation Unit so that the first vaccination is given right after the visit in the same health centre. Other check-ups are held at 8 months and at 18 months.

Enjoy your time with your baby

Find time to play with your baby. An excellent activity is placing the baby prone (on the stomach) on top of your tummy for several minutes. This activity not only helps to strengthen the baby’s upper body as he or she tries to lift up the head and eventually the torso, but also helps to form a strong bond between parent and baby. Quality time spent with a newborn is time well spent.

Dr Victoria Farrugia Sant’Angelo MD, MA, MMCFD is Medical Co-ordinator, Primary Child Health, and National Immunisation Programme Manager. This article has been brought to you by the Primary Health Care Department which offers services in the health centres, district clinics and in the community.

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