Common Problems

Most babies, at some time or another, will probably get a rash on their bottoms (diaper rash). To prevent diaper rash, keep the diaper area clean and dry by changing the diaper every time it is wet or soiled. If your baby has diarrhea or is on antibiotics, the possibility of developing a diaper rash is increased. Use protective cream such as petroleum jelly, A&D ointment, Desitin, or zinc oxide to help prevent or treat the diaper rash.

To treat diaper rash, expose your baby’s skin rash to air as often and for as long as possible.

If you are using cloth diapers:

• Remove plastic pants during the day as often and for as long as possible.
• If a strong ammonia smell is present, treat the diapers with a solution of bleach. Be sure to rinse thoroughly.
• Try washing diapers with a different soap and rinse carefully.

If you are using disposable diapers:

• Try changing to a different brand.

Call your baby’s doctor if your baby’s temperature is higher or lower than the normal range given below. You only need to take your baby’s temperature when you think he is ill. For children less than three months (90 days) old, take an axillary (armpit) temperature. It’s a safe method that works well for screening.

A normal armpit temperature range ranges from 97.7° F (36.5° C) to 99.5° F (37.5° C).

How to take an armpit (axillary) tempature

• Make sure your baby’s armpit is dry.
• Put the tip of the thermometer in your baby’s armpit, directly against her skin (skin should completely surround the tip of the thermometer).
• Close your baby’s armpit by holding her elbow against her chest.
• Follow the directions on your thermometer to determine how long you should hold it in place before reading it.

Note: As your baby gets older and less fragile, your baby’s doctor may suggest taking your baby’s temperature rectally (in the anus). The doctor can show you how to take a rectal temperature.

All babies cry a lot during the first few months of life. Your baby’s crying may mean he needs feeding, a diaper change, sleep, a temperature change, or comforting. Some infants cry every day in the late afternoon or evening. Feeding and changing may help, but sometimes even that doesn’t work.

If your baby cries more often than normal and can’t be comforted — or if you notice signs of illness such as a fever — contact your baby’s doctor.

Ways to cope with crying

Sometimes babies cry for hours at a time, and nothing seems to soothe them. Try the following techniques to help both of you cope:

• Check your baby’s basic comfort needs. Feed and diaper her — babies like to be dry, warm (but not hot), and full.
• Decrease your baby’s stimulation. Create a more quiet, calm, environment. Avoid sudden noises, keep the lights dimmed, and limit visitors.
• Hold your baby so he feels secure. Try swaddling him in a soft, warm blanket. Or, cuddle him skin to skin.
• Try anything that provides a slow, gentle motion like riding in a stroller or in the car. Also, try cuddling her in a rocking chair or letting her sit in an infant swing.
• Try singing, talking quietly to your baby, or playing the radio. Sometimes, running a vacuum, a humidifier, or a tape of a heartbeat may help.
• Try nursing longer on one breast to allow your baby to receive richer milk.
• Call a relative or friend. They may offer advice or watch the baby for a while. Crying can be frustrating — and you need support.
• Set aside time for yourself. Schedule time every day to have a nap or hot shower, go for a run, or walk around the block.

Is all this crying normal?

It may take awhile for you to learn how to comfort your baby when he cries, and that is OK — keep trying. Many young infants go through a “crying phase” when nothing seems to comfort them. Eventually, they grow to become more settled and are easier to comfort. Babies going through “the crying phase” tend to cry in the same ways.

Crying won’t hurt your baby, but it can be frustrating for you. It may help you to remember that most parents cope with this kind of crying at some point. Remember, your baby is not trying to manipulate you by crying. Picking him up will not spoil him. You can learn ways to keep yourself calm so you can take the best care of your baby. If you start to feel angry or upset:

• STOP. Put your baby down in a safe place like a crib or a playpen. If possible, call a friend or family member to take over.
• TAKE A BREAK. Do something to relax and calm down for 10 to 15 minutes.
• TRY AGAIN. Go back to comforting your baby when you feel calmer.

Is it colic?

If you’ve ruled out other causes of crying, your baby may have colic [KOL-ik] (irritable infant syndrome). Symptoms of colic include:

• Baby cries or is fussy for more than three hours per day.
• It is difficult to soothe your baby.
• Baby is happy much of the day, but becomes progressively fussier as the day goes on.
• Baby draws his knees up to his chest and passes gas, flails his arms, and frequently arches his back and struggles when held.
• Baby’s belly muscles may feel hard during crying.

Occasionally, colic is caused by sensitivity to food in the nursing mother’s diet. Cow’s milk products, such as cheese, ice cream, and butter, are common sensitivities. Other food items that may cause problems include stimulants (caffeine) and gas-producing foods.

Talk to your doctor if you think your baby may have colic. The cause of colic is unknown, but your parenting style is generally not a factor. Nor is feeding style. Breastfed babies are as likely to have colic as bottle-fed babies.

Jaundice is the yellowish coloring of the skin and eyes that is sometimes seen in newborns. Jaundice is caused by hyperbilirubinemia [hahy-perbil- uh-roo-buh-NEE-mee-uh] — a condition in which a substance called bilirubin [bil-uh-ROO-bin] builds up in the bloodstream and is deposited in the skin. Your baby is tested for high bilirubin before leaving the hospital.

A little jaundice is common in newborns for the first three to five days. The yellow color of jaundice starts at the head and gradually moves downward on the baby. As the baby’s liver breaks down bilirubin, the jaundice gradually disappears. However, in up to 5% to 6% of babies, bilirubin levels are high enough to require treatment. Treatment includes phototherapy (fluorescent light treatment) and frequent feedings of mother’s milk or formula. Treatment can usually be done at home, but sometimes hospitalization is required.

If your baby’s bilirubin level is above normal in the hospital — but not high enough to require treatment — your doctor may schedule you for a follow-up bilirubin test. It’s very important to have this testing done. If high bilirubin levels are not treated, some babies may suffer neurological (brain) damage.

That’s why it’s also important to notify your baby’s doctor if you notice your baby becoming more yellow or if the jaundice covers more of the body than when you were in the hospital. You should also notify your baby’s doctor if your baby becomes lethargic, is eating poorly, has an unstable temperature, or has behavior changes — these can all be signs of a high bilirubin level.

Prompt treatment is important to prevent permanent injury in a newborn. Frequent feedings of mother's milk or fomula will also help decrease jaundice.