A PAEDIATRIC DOCTOR ON 15 THINGS YOU DON’T NEED TO WORRY ABOUT
By Dr Victoria Wakefield, Paediatric Doctor
I have been a parent for almost six years and have two young children. In my time as a parent, I have been very blessed with healthy kids and only sought medical help twice.
However, I am a bit of a cheat, as the other important number of years I have up my sleeve are my almost 11 years of being a paediatric doctor. I probably should have started with that one.
Being a paediatric doctor has given my family and friends lots of advantages that I take for granted. I truly believe that knowledge is power.
I still have lots to learn about being a parent, but I wanted to share some of my top medical words of wisdom with you based on the information I have collected in my years on the frontline of paediatric medicine.
1. Be relaxed about your birth plan
Kids are impossible to predict, and this starts from conception. Baby will come when and how THEY choose to do. I have seen many distressed mothers pre and during labour because things have not gone to their plan.
In my experience having a rigid birth plan often causes unnecessary stress and anxiety. Once baby comes and is healthy, how they came matters very little.
2. Breastfeeding is hard!
It took me about two weeks (with each child) to really get to grips with breastfeeding. My nipples were very sore for at least two weeks, as the skin had to get use to being sucked and pulled (pile on that nipple cream).
Also, breastfed babies will initially feed more often as the only way you will eventually make more milk is by them sucking, so in the early days it feels like they are constantly on the boob. But because it’s initially painful and they are feeding lots at the start does not mean you are doing it wrong or they are not getting enough. I see too many mums giving up because it’s initially difficult, so they take that to mean they are doing it wrong.
Trust me once you are over the initial hump, it is easier for most women and you never look back. Breastfeeding mothers even get more sleep. However, if in the early days it’s excruciatingly painful get some help as the latch might be wrong or you might have mastitis (a breast infection).
Another tip is that most hospitals and GP’s have infant feeding specialists or lactation consultants so ask to be referred if you want some extra help.
3. Baby’s weight drops a bit
It is normal for baby to lose some weight in the first week of life. We expect up to 10% of baby’s birth weight being lost in the first seven days of life. Between 10-15% you probably need to talk to your midwife about a feeding plan.
So, if your baby loses some weight, particularly if its less than 10% of their birth weight, but they are active and well, don’t worry about it; its normal and expected.
You don’t need to supplement with formula and you don’t need to add formula to avoid this weight drop either. Baby should then regain their birth weight by two weeks of life with normal feeding.
4. Babies cry
Crying is the only way your baby knows how to communicate with you until they have mastered facial expressions, can grab things or talk. So, they cry for lots of reasons; hunger, being too hot, too cold, bored, lonely, wanting a cuddle.
Crying doesn’t always mean pain or being unwell. You will learn which cry means what, but that takes a bit of time, so until then just work your way down the above list.
The absolute truth is, no one really knows what causes colic. And, by colic I don’t mean trapped wind. I mean the baby that cries every evening for a few hours. The crying that goes through your brain like an ice pick, it makes you get in your car at 2am dressed in pyjamas and slippers and drive round the block. That is colic!
The medical definition of colic is crying more than three hours a day, three days a week for at least one week. Your baby looks angry, red faced, fists clenched, drawing up of the legs, it’s horrid. If you didn’t know better, you would think your baby is sick. But they are not, as after a few hours or, a lot of times, after a nice firm cuddle they settle.
A sick baby does not settle after a cuddle or a drive around the block. My first child had awful colic, we used to call it the witching hour. It would kick off around 8pm and would last for two and a half hours or so. It drove us crazy! Then I discovered the four S. They changed my life. They stand for
Sucking (dummy or finger)
look it up.
Apparently, colic is very rare in cultures that use baby wearing. So, I started using my baby carrier in the house and my baby transformed. I recommend baby wearing in the house to all the mums I see at work now.
It keeps your baby happy and your hands free, (multitasking at its best). Colic settles for most babies by 3-4 months. So be reassured it won’t last forever.
6. There is a fourth trimester
For the first three months of life, baby really wants to still be in the womb. So, the next best thing for baby is to be with you and on you. Baby wearing is great for so many reasons (as described above) and it’s even better if you have another child you need to keep up with. This season you should mainly be wearing your baby!
Furthermore, babies like movement, they spent nine months inside you moving, it reminds them of the good old times in the womb. The same goes for noise. You don’t need a silent house for your baby to sleep in.
You may have noticed with your previous baby or other people’s babies, they sleep best when out and about and they can hear the world going by. In your womb they had the constant sound of your heart beat and your body functioning. Babies like background noise.
7. Your baby may have some teenage issues
Around 2-4 weeks of life, baby may develop baby acne. It’s normal, it’s due to hormone shifts. Leave the spots alone, don’t pop them, don’t put any special creams on. Just keep the skin clean with water. It will pass within a few weeks.
New baby girls can also have little periods (yep, you heard that right), we call them withdrawal bleeds, it’s totally normal and lasts a few days. Finally, male or female babies might get breast buds and even lactate. That too shall pass and is normal.
Us paediatricians like fever. Fever is good, it helps little Johnny fight off that viral infection he has. The only time we don’t like fever is in babies under the age of 90 days. If your new baby gets a temperature above 38 degrees Celsius go to hospital.
Between 2 to 3 months they are only allowed a temperature after their immunisations. The fever post jabs should only last for 48 hours. That is a normal response to vaccines. Parents forget that being jabbed three times in your legs is painful. So, give poor baby some pain killers; baby paracetamol and ibuprofen are great painkillers.
Treat their pain, not the fever.
9. No such thing as a constipated breastfed baby
Up to 4-6 weeks of life, baby will poo pretty much after every feed. After that in formula fed babies, they should pass soft yellowy stools every day. However, in exclusively breastfed babies normal can be from a few times a day to, wait for it…every 10 days.
Breastmilk is processed and digested in a very different way to formula, very little goes to waste. (My son would go every seven days, we would call it “The Poo-nami! those were stay at home days) So, if your 4-week-old breastfed baby only starts poo-ing every seven days but is growing, happy, settled, and having lots of wet nappies, leave them alone, no orange juice or prune juice.
The only caveat in this is that if you as the breast feeder, are constipated then your baby might become too. You will know it, not by the frequency, but by the form, so the stools will be hard or pebble like. If that happens drink more water and eat more fruit and fibre and that should fix the problem for both of you.
Reflux is a normal part of baby development. It is only a problem and should only be treated if the baby is not gaining weight or it is causing a lot of discomfort and pain. Very rarely is a crying fussy baby caused by reflux.
My son had awful reflux, I changed him over 10 times a day because he just vomited after every feed. But it never bothered him. Most babies grow out of it once they are sitting up more and once they start solids.
By all means try the anti-reflux medications if you are in dire straits, but my experience is that they rarely make a big difference and they are a bit of a pain to give.
You can start weaning from four months if you think your baby is ready. When you start, I’d avoid starting with sweet things. Baby’s taste buds are open to anything and everything. They are more likely to eat their vegetables if you expose them to those tastes early.
Also, be very mindful of the faces you make when they eat. When eating broccoli for the first time they will naturally make that “bitter” face, don’t mirror that face, don’t read that as baby doesn’t like it. Just think how much you like that bitter gin and tonic taste.
Kids feed off our preconceived ideas about things, especially food. Also, to avoid constipation give them water with meals when weaning starts.
12. Keep talking
I often see children whose parents are concerned about their child’s development. The first thing I will say is that every child develops at different rates and in different orders. So, hard as it might be, try not to compare.
However, it is important to know when you need to be concerned. These are called developmental red flags. You can find them online. Delayed speech is a common worry I see in clinic. To help your child’s speech, talk to them lots. I talked at my kids constantly, and when I had nothing to say I read to them from day one.
Keep talking to your little ones, start reading to them from the start, even if it’s your current novel or trashy magazine.
Most rashes in children are caused by viruses, even the ones that look like hives. As clever as us doctors are, we don’t really have any treatments for viruses. Your child’s body will do that all on its own.
So, if your child develops a rash and the rash blanches (disappears when you press it), just keep an eye on it, if its itchy and hive- like try an antihistamine and give it a few days. If it’s still there, then see your GP.
14. Kids feel pain too
All too often I see a child who has been waiting in A&E for two plus hours, who has a sprain and as a result is not walking, is limping or refusing to use a limb. I ask parents if they have given analgesia and they say “No” because the child has not complained of pain.
Children don’t always complain, but if they are not using a limb or are limping, particularly after an injury, it’s because it hurts. So please give them some painkillers. It won’t mask anything serious, but it will certainly take the edge off most sprains and soft tissue injuries.
My daughter broke her leg running. I knew something was up as despite paracetamol and ibuprofen she still refused to walk. I’d advise giving pain killers first before rushing to A&E, they might well save you a needless trip.
My final tip is for emotional health. Love your kids unconditionally but give them consistent boundaries. What those boundaries are? You choose, but just be consistent.
Those are a few of my paediatric pearls of wisdom for new parents that I have found useful in my parenting journey so far; I hope you find them helpful.
But remember, if you are ever in doubt or are really worried about your child, seek advice; that’s what GPs and paediatricians are there for.