Common Concerns and ‘Mother – Worries’
Having a baby is a new and wonderful experience. As a mother you will be proud of your baby but the baby doesn’t seem to express its wishes in a language you understand. So its natural for you to be apprehensive and ask a million questions. If you have any questions, however silly they may seem to you, don’t be shy to ask them.

Cartoon of a woman with many queries.

Catch hold of an experienced person (your mom, mom-in-law, friend) or better still, your doctor. They can lay your doubts to rest and provide answers to your questions. Here are some of your common worries and questions, answered.

The first and the foremost worry that you may have is

Can I be a good mother?
Well, its natural for all mothers especially first time mothers to feel that way. Don’t worry!! Your baby and those around you and of course ‘we’ will prepare you for it.

Do I need a baby Nurse?
All depends upon whether you can afford one, but if you have enough leave and people around you, taking care of the baby by yourself should not be a problem. The father can of course take over when the mother is ‘down’.

Does my child need Circumcision?

If you have a male child you may wonder about circumcision. Circumcision is usually done for one of the following reasons.

On the other hand one may decide against a routine circumcision for the following reasons.

One may have to weigh the pros and cons. But the right to final decision is yours.

Aren’t disposable diapers supposed to be harmful?

No. If properly used, disposable diapers are not harmful in any way. Infact, they are quite convenient, as there is no washing and messiness, more so when you are travelling.Only factor to consider is the cost that can make daily use of disposable diapers a wee bit expensive.The only other problem with disposable diapers is having to go and shop for it. This can be now be done away with due to online shopping. The other problem is that some of them are not bio – degradable adding to the environmental pollution and clutter (not that green place activist will stage a ‘Dharana’ at your place).

Is it okay to smoke or drink occasionally?

No, smoking is a definite no-no. Even your spouse should quit smoking, as passive smoking is equally harmful to everyone around. As for drinking, an occasional glass of wine or beer will not cause any harm. However regular alcohol intake is definitely not advisable.

Is it okay to keep a Pet?

Well, even the most obedient of dogs can cause harm to your baby. So be careful if you have a pet around. 

• Don’t leave the child alone with a pet.

• As far as possible avoid direct / indirect contact of the baby with the pet.

• Get your pet completely examined by your veterinary doctor before the baby arrives home.

• Let your pet and get it used to sleeping alone, if it has a habit of sleeping with you.

• Train your pet and get it used to a baby by using life size doll.

• Keep a leash / cage ready when you get your baby home and the pet might show some hostile feeling towards your baby.

Is it necessary to take my baby to the doctor if everything is fine?

Before you are discharged from the hospital, the baby will also be given a through examination by the paediatrician. Subsequently if your baby is fine, putting on weight adequately, not crying excessively, etc. you needn’t take him to a doctor. The next visit to the paediatrician can be conveniently scheduled at the time of your own postnatal follow up with the doctor, usually 2 weeks after discharge from the hospital. Thereafter the baby will have to be taken to its doctor at regular intervals only for completing its vaccination / immunisation schedule       .   

The doctor has asked me to feed the baby every 2 – 3 hours, but my baby sleeps on for 4 hours sometimes 6 at a stretch!

As the hunger pattern of adults differs, so does the pattern of babies. Some babies may need breastfeeding even at 1 ½ - 3 hours. . After a good feed your baby may sleep longer. You can wait upto 3 hours. If the baby does not wake up, you can try to awaken it by

• Unswaddling.

• Removing all its clothes.

• Tickling the soles.

When it wakes up put the baby to the breast. If it goes back to sleep after a few sucks, jiggle the breast, stroke your baby, jostle him or change its position till it starts feeding again. At nighttime, feed him once before you go to sleep so that you don’t have to wake up more than once in the middle of the night.

Is there something wrong if my baby gets up with a startle or quivers its chin while crying?

The startling of the baby is a protective and normal reflex of the baby called the MORO’s REFLEX.The quivering of the chin may seem like as that of  ‘a veteran action in a melodramatic scene’. But do not worry. It is just that the baby’s nervous system is not mature enough. The quivering will not last for long.

My baby has a lot of spots or birth marks some of which keep changing.

You may notice lots of spots on your baby. Some of them are permanent and hence birth marks others are only temporary.

•     Strawberry haemangiomas (collection of dilated blood vessels) are soft raised strawberry red spots, which appear at birth or immediately after birth. They slowly fade to pearly grey colour and disappear completely by the age of 5 – 10 years. They are seen in 1 out of 10 babies. Treatment may be necessary only in about 1 in 1000 babies and that too for cosmetic purpose or rarely for bleeds.

•     Cavernous haemangiomas are seen in 0.1% babies. It is similar to a strawberry haemagiomas, but more lumpy and diffused. It grows rapidly in 6 months and continuous growing (but slowly) for next 6 months. It then shrinks and nearly vanishes by 10 years of age.

•     ‘Stork bites’ are pink coloured patches on the face and nape of the neck (by which the stork carried the baby, hence the name). They become lighter and generally fade by 2 years.

•     Port wine stain are purplish red spots, which appear anywhere on the body. They are usually flat and more or less permanent marks.

•     Café au lait spots are flat patches ranging from tan – dark brown colour, hence the name. They are seen more easily in the fair-skinned babies. If there are a lot of such spots inform your doctor, as there may be some other associated medical condition.

•     Mongolian spots are blue to grey spots seen on buttocks or back. There are more common in Blacks, Orientals and Indians. They disappear within 1 year of life.

•     Congenital naevi or moles are light brown to black in colour usually small and rarely very large. Large ones can be removed surgically for cosmetic purposes. These large ones have the potential to become cancerous later in adult life.

I have noticed a few white bumps on my baby’s gums when he cries. Could he be teething?
The chances of teething are very remote, though not totally ruled out. Those ‘bumps’ are more likely to be tiny fluid filled cysts – very common among newborns. They soon disappear, leaving the gums clear. Some babies have yellowish white spots on the roof of their mouths called ‘Epstein’s pearls’. They are quite insignificant and disappear spontaneously.

My baby has a tooth since birth is it normal?
Once in a while a baby may have a tooth since birth. It is not abnormal. It is usually removed if it is not firmly embedded as the child can swallow or choke as loose tooth. Another reason to remove it would be to facilitate breastfeeding and prevent bite marks. Once this tooth is removed the normal primary teeth come or erupt at the usual age. Rarely these are primary and may have to be replaced by dentures till secondary teeth erupt. 

My baby’s tongue is coated white and bleeds while cleaning it. What do I do?
This is called oral ‘thrush’ and is due to a fungal infection. The best way to tackle is prevention. Breast should be cleaned with water before and after feeds. The baby’s mouth is also wiped clean after very feed. If ‘thrush’ does come up local application of an antifungal lotion every 2 – 3 hours should be done, but only after consulting your paediatrician.

Today is day 3 of my baby’s birth and the baby is looking yellow. Does it have jaundice?
Yes! All babies normally show some amount of jaundice after birth. But this passes off usually within 7 – 10 days and namely 2 weeks. This is called physiological jaundice and is due to breaking up of RBC’s. No special care is needed as long as the bilirutrin levels are within acceptable limits and the baby is fine. In some special cases the jaundice may be due to certain conditions like infection, blood incompatibility (mother O/Rh-ve and baby A,AB,B/Rh +ve) or congenital diseases. This usually starts later than day2 – 3 of life. In these cases the paediatrician will inform you about it and will start some specific treatment.

Is it okay if I use a pacifier to quieten the baby?
During the first 2 – 3 days it is acceptable to do so as you may be quite exhausted. This will not be habit forming. But one has to stop this practice as soon as possible to prevent habit formation. You must also be very careful that the pacifier is kept clean. The best thing to do is to find out the cause of crying and act accordingly. The baby may be crying due to hunger, wet nappy, and colic or may simply be a fussy baby. Try to find out and act according to the situation.

The baby’s eyes are sticky and sometimes the baby has difficulty in opening its eyes. Is that a sign of infection?
Sometimes there might be clean discharge from the eyes of the newborn. Especially in the first 24 – 48 hour. This needs nothing more than a wipe with sterile wet cotton balls. If this discharge is persistent or has a ‘pus-like’ quality or if the baby’s eyes appear reddened, then it is better to inform your paediatrician and take appropriate action according to his / her advise.

My baby vomits out a yogurt / curd like product after meals. Is it that he doesn’t like the taste of my milk?

The baby brings out a curd like vomiting because of inadequate burping while feeding along with milk, the baby takes in equal quantity of air. When the baby is put in a lying down position immediately after feeding, this are brought out along with some quality of fermented milk that is present in the baby’s stomach.Hence it is important to burp the baby. To remove the air in the stomach before it is put to bed.

My baby head seem to be soft in the center and there is not underlying bone, so much so that when he cries the part bulges out !

The baby’s skull is not yet completely formed. The individual bones are not yet fused together as in adults. This is necessary so that the skull can accommodate the growing brain of the child. This opening / defect in the center of the head usually closes latest by 1 ½ years.

I think my baby has a squint !

Don’t be alarmed if you see that your baby is cross-eyed (i.e. ‘looking London – going Tokyo!’ as commonly called). This is because the eye muscles need to be developed and the focussing mechanism of eye also needs to be developed. Slowly but surely the baby will gain control and stop being cross eyed.

All these months we were longing to hear our baby’s 1^st cry but now sometimes it does cumbersome when it cries often.

When the initial novelty wears off, the truth of the situations dawns on you. Your baby is, as mentioned earlier a bundle of joy to behold but also a great responsibility. The only language the newborn knows is crying. Crying for all its physical and emotional needs and sometimes may be just for the heck of it. Especially for the new mother, at times, crying of the baby may be quite irksome. If this happens to you, do not be alarmed! This happens to all mothers. Check why the baby is crying: hunger / wet diapers / flatulence / colic, etc. and act accordingly. Your husband can definitely help you take care of the crying baby some of the times.

Sometimes I see red streaks or coffee brown particles in the baby’s spit up !

If you see such a red streak or coffee brown particulate matter in the baby’s vomit don’t be alarmed.

Before you panic, check if it is your own blood! Check your nipples to see if they are cracked and bleeding. If yes, you know where the blood comes from. The acid normally present in the stomach denatures the blood to dark brown colour. If you don’t find any crack in your nipples contact your paediatrician and if nipples are cracked call your doctor / gynaecologist so that necessary treatment for cracked nipples     can be given.

Does my baby need any Vitamin supplements? My paediatrician has not prescribed anything but my neighbour’s son is receiving some health tonics prescribed by her paediatrician.

Paediatricians (child specialist) are divided in their opinion and prescription for newborn. There is no rule, which says that your baby needs vitamin supplement. So don’t worry if your paediatrician has not prescribed any.You can always pose this query to your paediatrician and act according to his suggestion.

How do I know of my baby is a Colic baby? He seems to cry so often!
It is estimated that 1 in 5 babies has crying spells that last for hours and are severe enough to be labelled ‘colic’. Colic differs from ordinary crying in that the baby seems to be crying, rather screaming inconsolably for 2 – 3 hours, sometimes much longer. Colic generally begins during the 2^nd or 3^rd week of life, and is at its worst by 6 weeks. It usually starts waning by 12 weeks and the baby appears to be cured by the 3^rd month. However, there is no clear definition of what exactly colic is, or how it differs from other types of problem crying. Many theories have been put forth ranging from heredity, complications during pregnancy and childbirth to gastric discomfort. Almost all these theories have been completely or partially rejected.

Coping with Colic

A colicky baby may turn out to be more then a handful. You may feel exhausted and frustrated. There may be times when you momentarily nurture negative feelings towards your child only to be ashamed of yourself later! This is natural and happens to many a parent of colicky kids. The ‘rightest’ thing you can do is to try and cope with your baby’s crying as calmly as possible. The important thing is to realise that colic in a baby is not the fault of the parents.

(i)  Prevention:

It has been shown that babies who are carried in the arms or in a baby carrier, for at least 3 hours cried much less than those carried less. Carrying gives the baby a sense of physical closeness to the mother (akin to life in utero). It also helps the mother get better attached to the baby’s needs.

(ii) Comforting the crying baby:

There are many ways suggested to comfort a crying baby, not, all of which may be always effective. One must be careful to give each method a fair trial before switching to another.

The following steps may be tried:

• Rhythmic rocking either in your arms, a carriage or a cradle. You can test your baby’s response to different types of rocking to see what calms it the best i.e. whether fast rocking or slow whether side to side rocking or up and down, etc.

• A ride in a pram, stroller or family car.

• Walking around with the baby often works, though it can be quite tiring.

• Swaddling the baby tightly is very comforting to some infants.

• Cuddling the baby in your arms gives him a sense of security and often calms it. Hold the baby pressed close to your chest encircled snugly by your arms.

• A warm water bath can do the trick, but only if your baby likes the bath.

• Singing: your baby may be soothed by music, either by soft lullabies, fast tunes or sprightly rhymes. If you find a tune your baby likes, don’t hesitate to sing it over and over most babies love repetition.

• Pressure tactics: lying across an adult lap, tummy down, back being patted often makes colicky babies more comfortable.

• Colic carry: some colicky babies are soothed by the pressure applied to their abdomen when they are carried in this position.

• Lastly your paediatrician may be helpful and prescribe medicines to be taken in an emergency.

Some babies appreciate your help in getting their thumb to their mouth for their sucking enjoyment. Others find pleasure in a pacifier. But remember to resort to this measure after all possible causes of crying have been eliminated.