Our experts answer three of your baby concerns and queries.
Q: My 10-week-old babys’ poo is usually pale yellowish-brown and can be quite hard. It looks like he occasionally has bits of blood in them, although he has no cuts near his bottom and seems to be in no pain at all. Is this constipation?
A: There are two aspects to this: the first and most important is whether or not there is blood in the stool. It’s usually possible, just by looking, to determine if it is blood, but sometimes it’s necessary to send the stool for analysis. If it is blood, one has to establish from where in the gastrointestinal system it is coming from, as some causes are innocuous but others may be serious.
The colour of the blood may be a clue: dark red, almost black, suggests that the origin is the stomach or the first part of the small intestine; maroon suggests that it comes from the small intestine or first part of the colon; bright red suggests the rectum or anus. Something called ‘redcurrant jelly like stools’ is typical of a serious condition called Intussusception.
It’s important to note whether the blood is mixed in with the stool, or only on the surface. If it’s bright red and on the surface (and the stool is hard), this would imply an anal fissure due to constipation.
The absence of pain with bloody stools is also significant.
The second aspect is that of constipation. Constipation’ describes hard, pellet-like or ball-like stools. It doesn’t refer infrequent stools. Passing a constipated stool may not be painful or difficult, as it depends on the size of the stool relative to the baby or child.
It’s difficult to answer this question more specifically as further information is needed, e.g. about feeding and weight gain. My advice is that your baby should be seen by a doctor so that all of these aspects can be assessed. – Dr Deon Smith, Paediatrician
Q: My five-month-old has always breastfed well, but now he’ll only feed for about five minutes and is then hungry again an hour or so later. He seems perfectly happy, but I’m finding it hard to cope with feeding him so often. What can I do?
A: Five-month-old babies are very easily distracted. Some babies manage to drink very efficiently and can empty the breast in a short time. Also, if the weather is very hot, babies may want to quench their thirst more frequently; but they’re also much more interested in everything that’s happening around them. Some moms find it easier to cope with these frequent small feeds if they keep their baby in a sling, so that they don’t have to stop what they’re doing to feed the baby.
Sometimes it helps to sit in a quiet room with as little distraction as possible, or to breastfeed when baby is sleepy or has just woken up. This will encourage him to drink for longer. If your baby is growing well, and is otherwise happy, it helps to realise that this is a phase, and it will pass. In some cultures, babies feed every 20 minutes, but our society expects much longer intervals between feeds. These expectations may not be fair. You’ll probably find that when your baby starts solids in a few weeks’ time, the gap between breastfeeds will become longer. Perhaps you could get in touch with a breastfeeding support group in your area, so you can exchange experiences with other moms and find out how they cope. – Le Leche League
Q: My three-week-old baby has white pimples on her face. They don’t look sore, but I’m worried. What can I do to make them go away?
A: The majority of rashes in the newborn period are innocent or benign rashes. The most common of these conditions include neonatal acne, erythema toxicum and milia, to name a few. These conditions are not harmful, they require no specific treatment and they resolve on their own. Good skin care includes a gentle soap and baby moisturiser, and no harsh detergents. A plain aqueous cream works well to keep the skin well hydrated. There are however a few less common conditions that require a prompt diagnosis and require appropriate treatment, e.g seborrheic dermatitis/ secondary superficial infections/ congenital infections, etc. Have your doctor review her skin to put your mind at ease. – Dr Rabeen Lutchman, Paediatrician
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