Common Pediatric Concerns: Newborn Care Questions Answered

Care-related questions?

Hello, doctor.
May I ask: 1.
What problems can shaking a newborn cause? 2.
Is the intermittent wheezing sound in a newborn (the father has asthma) caused by a cold? 3.
How can we improve long-term vomiting in a newborn (sometimes in large amounts)? 4.
There are unexplained red rashes on the newborn's face, possibly related to "胎火" (heat in traditional Chinese medicine).
Is it safe to consume glucose? What is the recommended dosage? 5.
By when will Mongolian spots typically disappear? 6.
Is it necessary to use talcum powder in the summer? 7.
How can we improve "澎風" (a term that may refer to excessive wind or gas)? Thank you.

Ning, 20~29 year old female. Ask Date: 2015/12/26

Dr. Xiao Kaiwen reply Pediatrics

1.
Shaken Baby Syndrome may occur if an infant's head experiences significant forces of acceleration and deceleration, which can lead to brain injury without any visible external trauma.

2.
The likelihood of newborns catching a cold or developing asthma is low; most cases may simply be due to the softer tracheal cartilage producing a particular sound.

3.
The muscle at the junction of the esophagus and stomach in newborns is not fully developed, leading to incomplete closure, and the small stomach capacity makes them prone to spitting up.
As long as weight gain is normal, this will improve with age.
Physical methods include feeding smaller amounts more frequently and keeping the infant upright or semi-upright for a period after feeding to allow gravity to help move the milk into the stomach.

4.
Most rashes on a newborn's face will resolve over time; it is advisable to consult a pediatrician.
Newborns are not recommended to drink glucose water.

5.
Mongolian spots may not disappear at a specific time (larger spots tend to fade later, while smaller ones may disappear sooner), but they are generally benign and will eventually fade, so there is no need for concern.

6.
Baby powder can be used, but it should be kept away from the mouth and nose area (such as the neck), as inhaling mineral-based powders can be harmful to infants.

7.
As long as the infant passes gas after feeding, has normal bowel movements, does not experience severe spitting up, and has a soft abdomen, some degree of abdominal distension is normal.

Reply Date: 2015/12/26

More Info

When it comes to caring for newborns, parents often have a multitude of questions and concerns. Here, I will address some common pediatric issues that new parents may encounter, based on the questions you've presented.

1. Shaking a Newborn: Shaking a newborn can lead to serious consequences, most notably Shaken Baby Syndrome (SBS). This condition occurs when a baby’s head is violently shaken, leading to acceleration-deceleration forces that can cause severe brain injury, bleeding, or even death. The infant's brain is still developing and is particularly vulnerable to such trauma. It is crucial to handle newborns gently and avoid any form of shaking.

2. Wheezing Sounds in Newborns: If a newborn is making wheezing sounds, it is essential to consider the context. While it is less common for newborns to have asthma, they can exhibit wheezing due to other factors such as respiratory infections or even normal anatomical variations like soft tracheal cartilage. If the wheezing persists or is accompanied by other symptoms like difficulty breathing, it is advisable to consult a pediatrician for a thorough evaluation.

3. Frequent Spitting Up: It is common for newborns to spit up, especially since their digestive systems are still maturing. This can be due to a condition known as gastroesophageal reflux (GER), where the contents of the stomach flow back into the esophagus. To help minimize spitting up, parents can try feeding smaller amounts more frequently, keeping the baby upright for 20-30 minutes after feeding, and ensuring that the baby is burped adequately during and after feedings. If the spitting up is excessive or accompanied by poor weight gain, a pediatrician should be consulted.

4. Rashes on Newborns: Newborns often develop rashes, which can be due to a variety of reasons, including baby acne, eczema, or heat rash. If a rash appears on the face, it is generally advisable to consult a pediatrician for an accurate diagnosis and treatment plan. Regarding the use of glucose water, it is not recommended for newborns unless specifically advised by a healthcare provider, as it can interfere with their nutritional needs.

5. Mongolian Spots: Mongolian spots are benign blue or blue-gray marks that often appear on the lower back or buttocks of newborns, particularly in those with darker skin tones. These spots typically fade over time and can disappear by the age of 4 or 5, but some may last longer. They are harmless and do not require treatment.

6. Use of Baby Powder in Summer: While baby powder can help absorb moisture and reduce friction, it is essential to use it cautiously. Talcum powder should be avoided due to potential respiratory risks if inhaled. If parents choose to use powder, it should be applied away from the baby's face and in well-ventilated areas. Alternatives like cornstarch-based powders may be safer options.

7. Managing Gas in Newborns: It is normal for newborns to experience gas, which can lead to discomfort. To help alleviate this, parents can try gentle tummy massages, bicycle leg exercises, or holding the baby in an upright position during and after feedings. If the baby seems excessively fussy or uncomfortable, it may be worth discussing with a pediatrician to rule out any underlying issues.

In summary, while many concerns regarding newborn care are common and often manageable, it is always best to consult with a pediatrician for personalized advice and to ensure the health and well-being of the child. Regular check-ups and open communication with healthcare providers can help address any concerns and provide reassurance to new parents.

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