Newborn illnesses are not uncommon, with jaundice, umbilical granulomas, umbilical hernias, baby acne and colic being frequent concerns. Should you adopt a wait-and-see approach or call the doctor immediately? Use these pointers to navigate any doubt.
The most common newborn illness post birth is jaundice. It’s a condition where your baby’s skin turns yellow because of an excess of bilirubin in her blood, says paediatrician Dr Jonda Kerner.
Bilirubin is produced by the normal breakdown of red blood cells and passes through the liver, which releases it into the intestines as bile (a liquid that helps with digestion). But most newborns have an immature liver – so a mild jaundiced yellowing isn’t necessarily unexpected or a concern.
But it’s how yellow your baby turns that makes the difference, because if the skin and sclera of the eyes have taken up all the bilirubin they can, then the bilirubin is absorbed by the brain, cautions Dr Kerner.
Severe jaundice that isn’t treated can cause deafness, cerebral palsy, or other forms of brain damage. In rare cases, jaundice may be a sign of another condition, such as an infection or a thyroid problem, explains Dr Joy Fredericks, a paediatric neonatologist and head of the neonatal unit at Rahima Moosa Mother and Child Hospital in Johannesburg.
Jaundice usually appears around the second or third day of life (when moms and babies typically leave the hospital), so it’s important that parents carefully monitor for signs of the condition.
Typically, a jaundiced baby’s skin will appear yellow first on the face, then the chest and stomach, and finally, the legs. It can also make the whites of a baby’s eyes look yellow, says Dr Fredericks. “Jaundice can be hard to see, especially in babies with dark skin. If you’re unsure, gently press the skin on your baby’s nose or forehead — if jaundice is present, the skin will appear yellow when you lift your finger.”
When to call the doctor
It is difficult to tell how significant jaundice is just by looking at a baby, so any baby with yellow eyes or skin should be checked by a doctor, advises Dr Fredericks. The doctor might take a small blood sample to measure your baby’s bilirubin level. Some use a light meter to get an approximate measurement, and then if it’s high, take a blood sample.
Dr Fredericks also advises you call your doctor immediately if:
- Your baby has jaundice during the first 24 hours of life.
- The jaundice is spreading or getting darker or more intense.
- Your baby starts to look or act sick.
- Your baby is not feeding well.
- You feel your baby is sleepier than usual.
- The jaundice persists for more than two weeks.
During pregnancy, the umbilical cord passes through a small opening in your baby’s abdominal muscles. This opening normally closes just after birth. But if the muscles don’t join together completely, then this weakness in the abdominal wall may cause an umbilical hernia, explains Dr Fredericks.
This hernia creates a soft swelling or bulge near the navel, which you may notice when your baby cries, coughs or strains but may disappear when your baby is calm or lies on his back.
In children, umbilical hernias are usually painless and close on their own by age one or two years, (though some take longer), reassures Dr Fredericks.
“Your doctor may even be able to push the bulge back into the abdomen during a physical exam. Although some people claim a hernia can be fixed by taping a coin down over the bulge, this ‘fix’ doesn’t help and may cause infection.”
Complications of an umbilical hernia are rare but can occur when protruding abdominal tissue of the intestine becomes trapped. This reduces the blood supply to the section of trapped intestine and can lead to umbilical pain and tissue damage, she explains.
When to call the doctor
If you suspect that your baby has an umbilical hernia, talk to your health care provider. And, seek emergency care if your baby has an umbilical hernia and:
- Appears to be in pain.
- Begins to vomit.
- The bulge becomes tender, swollen or discoloured.
This is a small, red stalk of scar tissue on a newborn’s bellybutton after the umbilical cord has fallen off at about one week of age.
You’ll notice a red or pink stalk of tissue in the baby’s bellybutton area and possibly some redness at the rim of the belly. There may also be some oozing or bleeding but this normally doesn’t hurt, reassures Dr Fredericks.
When to call the Doctor
Call your doctor if you notice a lump forming at the bellybutton stump, advises Dr Fredericks. And seek immediate medical help if:
- Your baby has a temperature of 38°C or higher.
- You see abdominal redness.
- You notice foul-smelling drainage or pus coming out from your baby’s bellybutton.
More about the experts:
Dr Jonda Kerner studied her pre-med in Vienna, Austria. Thereafter she was trained at Tygerberg Hospital and surrounding Hospitals in the Cape Town area. She worked for six months in Paediatrics in Austria as a Medical Officer before she started her specialisation. Learn more about Dr Jonda Kerner here.
Dr Joy Fredericks qualified as a medical doctor at the University of Witwatersrand in 1997, as a paediatrician in 2004 and as a neonatologist in 2011. She is also qualified in paediatric palliative care and has a keen interest in neonatal pain management. Learn more about Dr Joy Fredericks here.
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