Concerns About Baby's Feeding, Urination, and Skin Health - Pediatrics

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Milk volume and urination time?


Hello, doctor.
Our baby has just turned three months old.
I'm not sure about the current weight, but I know that at two months, during the vaccination, the weight was 5.6 kg.
The baby is fully formula-fed and currently drinks about 150-180 cc per feeding.
During the day, the baby feeds approximately every 4.5 hours.
In the first two months, the baby would wake up crying when it was time to feed every four hours, but now sometimes the baby sleeps for six to seven hours at night without crying for a feed, even if they wake up early; they just wave their arms and legs as if exercising.
So, there are days when the baby might only have four feedings, and the total milk intake seems low.
I'm a bit worried that the baby might not be getting enough milk.
Should I wake them up at night to feed, or is it okay to wait until they wake up hungry? During the day, I'm concerned about diaper rash, so I change the diaper immediately whenever I see it's wet, which sometimes means changing two to three diapers within an hour.
However, recently, there are times when the baby sleeps for four to six hours without urinating (even though I may have changed three diapers within an hour before sleep).
Seeing such a long duration without urination makes me worried.
Is this normal? (After waking up and feeding, the baby starts to urinate, and the urine is clear and light yellow.) Does the baby hold their urine while sleeping? However, during daytime naps, the baby still urinates normally.
Additionally, I would like to ask about a small area on the baby's scalp that feels crusty, but there are no visible abnormalities.
Could this be due to inadequate cleaning? Also, the area around the eyebrows seems relatively dry, and I'm not sure if it's due to dryness or itching, as the baby tends to rub it, causing some redness.
I've applied a little lotion, and it seems to improve.
Do these issues require immediate medical attention, or should I just observe them for now and mention them during the next vaccination appointment? Thank you, doctor, for taking the time to respond.

Niming, 30~39 year old female. Ask Date: 2018/03/02

Dr. Lin Yishou reply Pediatrics


Please consult a neonatologist or a pediatric nephrologist.
Thank you.

Reply Date: 2018/03/02

More Info


As a new parent, it's completely normal to have concerns about your baby's feeding, urination, and skin health. Let's address your questions one by one, providing reassurance and guidance based on medical knowledge.


Feeding Concerns
At three months old, your baby is likely consuming between 150 to 180 cc of formula per feeding, which is within the normal range for a formula-fed infant. It's also common for babies to start sleeping longer stretches at night, sometimes up to six or seven hours, without waking for a feed. If your baby is gaining weight appropriately, is active, and has a good number of wet diapers, then you can feel confident that they are getting enough nutrition.
For infants, the general recommendation is to feed on demand. If your baby is sleeping and not showing signs of hunger, such as crying or fussing, it is usually fine to let them sleep. However, if you notice that your baby is consistently skipping feeds or seems unusually lethargic, it may be worth waking them for a feed.

Urination Patterns
It's great that you're attentive to your baby's urination patterns. Babies typically urinate about six to eight times a day, but this can vary. If your baby is sleeping for longer periods, it's not uncommon for them to go several hours without urinating. As long as the urine is clear and light yellow when they do urinate, this is a good sign of hydration.
If your baby is having fewer wet diapers during the day but is still producing urine after waking, this is generally not a cause for concern. However, if you notice any signs of dehydration, such as a dry mouth, lack of tears when crying, or a significant decrease in urination, you should consult your pediatrician.


Skin Health
Regarding the scab-like area on your baby's scalp and the dryness around the eyebrows, these could be signs of common skin conditions in infants, such as cradle cap (seborrheic dermatitis) or eczema. Cradle cap often appears as yellowish, scaly patches on the scalp and is usually harmless. It can be treated with gentle washing and moisturizing. If the area seems inflamed or if you have concerns about infection, it would be wise to consult your pediatrician.

For the dryness around the eyebrows, applying a gentle, fragrance-free moisturizer can help. It's good that you've noticed improvement with the lotion. If the redness persists or worsens, or if you see any signs of infection (like oozing or increased redness), it's best to seek medical advice.


Conclusion
In summary, your baby's feeding and urination patterns seem to be within normal limits, especially if they are active and gaining weight. Continue to monitor their skin health, and don't hesitate to reach out to your pediatrician if you have any concerns. Regular check-ups are a great opportunity to discuss any issues and ensure your baby is developing healthily. Remember, every baby is unique, and what works for one may not work for another, so trust your instincts as a parent and seek guidance when needed.

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