problems can be a
major challenge for
new parents, especially
since infants are unable to
communicate their discomfort
and needs. In the first of a
two-part article, Dr Alvin Ngeow,
Consultant, Department of
Neonatal and Developmental
Medicine, Singapore General
Hospital (SGH), highlights five of
10 common problems, and offers
simple solutions for concerned
parents. The second part will be
published in the next issue.
About 60 per cent of full-term
babies and 85 per cent of preterm
babies suffer from jaundice.
Most cases are physiological
jaundice, which is generally
harmless and relates to the
immaturity of the baby’s liver.
Doctor’s advice: Prolonged
jaundice may have lifelong
implications. If a four- to
six-week-old baby continues
to suffer from jaundice, further
medical checks and blood tests
may be recommended.
Red flags: Pathological
jaundice tends to start on the
first day of life and advance
quickly. It can be due to infection, inherited genetic problems, or
the mother and baby belonging
to incompatible blood groups.
Extremely high jaundice levels
may cause brain damage.
This is usually due to
gastroesophageal reflux since
the muscle tone between the
food pipe and the stomach is not
very well established. It takes one
hour for the baby’s stomach to
empty milk into the intestines, so
if parents put him back into the
cot immediately after a feed, lying
down may cause him to regurgitate.
Doctor’s advice: Hold your
baby with his head in an elevated
position for 15 to 20 minutes
after a feed to give him time to
partially empty the stomach.
Red flags: Gastroesophageal
reflux disease is less common, and
refers to more severe cases, where
the stomach acid burns the food
pipe and causes heartburn. The
infant may arch his back or even
refuse to feed. Vomiting may also
be due to urinary tract infection, a
blockage in the stomach, or head
injury or infection.
For babies less than four to
five months old, colic generally
refers to more than three hours
of crying a day, for more than
three days a week, and for more
than one week. Although it has no
known cause, it is usually harmless
and resolves at around three
months of age.
Doctor’s advice: Check if the
baby is hungry, tired, or needs a
diaper change before considering
if it is colic. In cases of severe
colic, try introducing a probiotic
for breastfed babies, or switching
to more easily digestible partially
hydrolysed milk formulas. Colic
and crying can push parents
into postpartum depression, so
stressed parents should try to
take time off and get help from
someone they trust.
Red flags: Persistent crying
along with symptoms, such as
fever, a drop in body temperature,
and extreme changes in babies’
activity level, may suggest other
illnesses. It is best to seek prompt
This is due to infants’ lax
abdomen muscle wall, which has to
hold in many internal organs and
some pelvic organs. Mild distension
can also be due to a recent
milk feed or because the baby
swallowed a lot of air while crying.
Doctor’s advice: This is normal
so parents need not worry.
Red flags: Seek medical advice
if the abdomen is very distended,
and other symptoms, such as
vomiting or the lack of bowel
movement, are present. This can be
caused by air, fluid, faeces, enlarged
organs, or in rare cases, tumours.
The back of a baby’s head can
appear flat due to repeated
pressure from the bed when it is
lying down. In many cases where
one side of the cot is facing the wall,
one side of the infant’s head may be
flatter than the other, as the baby
is prompted to turn outwards rather
than staring at the wall.
Doctor’s advice: Reduce
pressure on the back of the head
by alternating the head position.
Try positioning the baby’s head
alternately on the two ends of the
cot so that when he looks outwards,
he will either be looking to the right
or to the left. Parents may also
consider helmet therapy or approach
a physiotherapist for stretching
exercises for the baby’s neck.
Red flags: Doctors will check
to eliminate the possibility of
craniosynostosis, the premature
fusion of the cranial sutures.
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