Sunday, April 21, 2013

A Practical, Up-to-Date Guide for Parents — Common Problems and Worries -- Part 1

By, Jeff Beaumont


Skin
Babies' skin just isn't as smooth and clear as the advertisements say it is. Almost every baby develops a fine pink or red rash whenever the skin is irritated by rubbing on bedclothes, by spitting up, or by very hot weather. Almost all of these fine pink rashes will go away promptly if the skin is bathed with clean water whenever it is dirty, and washed with mild soap once a day.
Many babies develop waxy scabs on the scalp and forehead, called "cradle cap" or "seborrhea." Daily scrubbing with mild soap and a wash cloth will usually keep this under control.
Small, red, blotchy "birthmarks" on the eyelids and back of the neck are so common that they are called "stork bites." They usually show up when the baby is between 1 and 4 weeks old. They go away by themselves after a year or so, and cause no trouble of any kind. There is nothing to do but wait.
Bright red raised "strawberry marks" are also quite common. They appear after one or two months, grow rapidly for a few months, stop growing and gradually disappear. Unless your baby has one that is particularly large or in a spot where it is constantly being irritated, it is best to let it go away by itself.
Large areas of pale blue discoloration, called "mongolianspots" are common, especially on the trunk of dark skinned infants. They become less obvious as the child grows older and have no importance.
Diaper Rash—Urine and bowel movements are irritating to the skin, especially when they stay in contact with the skin for a long time.
Prevent diaper rash by changing diapers frequently, by rinsing the diaper area with clean water at each diaper change, by rinsing diapers thoroughly after washing, and by applying a layer of zinc oxide paste (you can buy it at any drug store) to any irritated area.
If your baby gets a diaper rash in spite of this, you should:
  • Leave off the plastic pants (or plastic covered disposable diapers) except when absolutely necessary. Using 2 or more cloth diapers at nap time and at night will make this less messy.
  • Leave the diaper area completely uncovered for a few hours each day (nap time or early evening is most convenient); put a couple of diapers under the baby to prevent soiling.
  • Apply a thin layer of zinc oxide paste to any irritated area after cleansing at each diaper change.
When to Worry—Any pimple or rash that gets bright red and enlarges, or that develops blisters or pus, may be the beginning of an infection that will need medical care. You can soak such a rash with a washcloth or towel wrung out in warm water, and keep it clean by washing with mild soap and water twice a day. If it gets worse, or if it doesn't get better in 24 to 48 hours, you should get medical advice.
Any rash that looks like bleeding or bruising in the skin should be seen by a doctor promptly (unless you know it really is a group of bruises).
Legs and Feet
Most babies' legs and feet don't look "normal" until the child has been walking for several years! The feet seem to turn in or out in the first year of life. By age 12 to 18 months the legs look bowed.
Almost all of these funny-looking feet and legs are perfectly normal and will gradually straighten out as babies run, play and climb. If you can move the foot easily into a "normal" looking position, and if the foot moves freely when the baby kicks and struggles, it is almost certainly a normal foot that developed a bend or twist while the baby was sitting on it during your pregnancy.
You won't cause bowed legs by pulling your baby into a standing position or letting your baby walk or stand "too early." Also, babies won't walk any sooner by being placed in a walker—which usually isn't much fun for babies anyway.
Umbilical Hernia—Swollen Navel
About one-fourth of all babies develop a swelling at the navel. This usually grows rapidly for several months, then grows with the baby for several months, then gets smaller and disappears. Large hernias may not go away until the child is 4 to 6 years old. The bulge often gets tight or tense when the baby cries or coughs.
Since these hernias almost always go away if they are left alone for long enough, there is no reason to have them repaired by surgery. They almost never cause any kind of trouble or pain. Occasionally a 4- to 6-year-old child may be embarrassed by a particularly large hernia, and it can be repaired at that time. By waiting, you will almost certainly save your baby an unpleasant and unnecessary operation.
Genitals
The boy's penis and scrotum and the girl's clitoris and labia are usually rather large at birth. They get slightly smaller over the next few weeks.
A girl may have a slight white creamy discharge from her vagina in the first few weeks, which is normal. It should become less and less and should not irritate the skin. Get medical advice if it becomes worse or if she develops a discharge after the first week or two. Any bulge or lump in a girl's genitals should be checked by a doctor.
One or both of a boy's testicles may seem particularly large, and be surrounded by a water sac or "hydrocele." Hydroceles are painless, cause no harm and go away without treatment, usually within a few months. Seek medical care for any swelling in the groin, and seek medical care immediately for any painful swelling in the groin or testicles.
If you want your boy circumcised, have it done while you are still in the hospital. It is not necessary, and it should almost never be done as a special operation once you and he have left the hospital (except for religious circumcisions).
A circumcision should heal completely within a week to 10 days. The tip of a circumcised boy's penis may become irritated by the diaper. Put a little vaseline or zinc oxide paste on the irritated area each time you change the diaper.
If your boy is not circumcised, don't try to pull the skin back over the tip of the penis. It will hurt and irritate. As he grows the skin will gradually loosen until it will pull back with ease (it sometimes takes as long as 3 or 4 years).
Sucking
Most babies get their thumbs and fingers in their mouths and suck on them. Many seem to find it especially enjoyable and do it often. It causes no harm and can be ignored.
Some parents don't like the looks of thumb and finger sucking and substitute a pacifier for the thumb. This also is fine and the pacifier can be thrown away toward the end of the first year. But don't substitute the pacifier for the attention, food or diaper changes that your baby wants and needs when he or she is crying! And don't use a bottle of formula or juice as a pacifier!


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