Baby health Q&As with our health visitor

Is your little one constipated?

Q. My 8 month old is constipated, but refuses to take any extra water. Can I add more to her bottles?

A. You should never change the way formula milk is made up by altering the recommended milk/water ratio as it interferes with the effectiveness of the milk and can cause problems for your baby’s kidney function. As long as she has plenty of wet nappies, her fluid intake is probably OK.

In terms of her constipation, if she’s weaning, keeping skins on fruit and vegetables such as potatoes, cucumber and apples will help. Movement, like kicking, will promote bowel activity so give her more floor time too.

Q. I had a very difficult birth and keep having flashbacks about it. I want to move on, but I can’t. What can I do?

A. The memory and impact of labour stays with mums for a long time, even more so when it doesn’t go to plan. You need to try and make sense of your birth by clarifying what happened and working through the sequence of events. Try writing down what you remember and if you had someone with you, talk to them as they may be able to shed extra light on things.

Your midwife will be invaluable in explaining things and discussing your delivery with you. She’ll also be able to arrange a meeting with your obstetrician, if it’ll help. It may be useful to go through your notes so you can understand why certain decisions were made. It’s important that you tell your story as often as you need to, and other new mums will understand this. But if things don’t get better, ask your health visitor about talking to a counsellor about the experience, too.

Q. My baby constantly brings up milk. Someone said it could be reflux, but how can I tell for sure?

A. One of the most common signs of reflux is difficulty in feeding, so you’re on the right track. Reflux happens when your baby’s stomach contents come back up into his food pipe or mouth. It’s because the muscular valve at the end of his food pipe, which keeps milk in his tummy, hasn’t developed properly yet. He may arch his back, scream and vomit frequently. You may also notice he has an erratic sleep pattern, excessive hiccups and poor weight gain. Take him to your GP for a diagnosis and be prepared to give a detailed history of how he is, including how often he’s been sick and cried. Medication can help but there are other things you can try out to help relieve his symptoms. Feed him in an upright position and don’t lie him down for at least 30 minutes after his feed. Offer smaller, more frequent feeds in a calm, quiet environment to prevent him getting agitated, and dress him in loose clothing, as this will reduce any pressure on his tummy.

Q. What can I do to relieve my baby’s cradle cap, which looks horrible and sore?

A. Cradle cap is a common scalp condition caused by overactive glands producing too much oil. This causes scalp cells to grow more quickly than they can be shed, leaving crusty, patchy skin, which can be red and sore looking. Avoid picking at the skin as this can cause discomfort and lead to infection. A good treatment is to softly massage your baby’s head with olive oil, allowing it to soak in overnight if possible, before brushing any loose skin off in the morning with a soft baby brush. Getting into a daily habit of brushing your baby’s head (even if he’s bald) will help remove dead scalp cells. There are also mild, medicated shampoos that can help. For most babies, though it looks sore, it doesn’t cause any real problems and usually goes after the first year.

Q: Can a 7 month old get constipated? My baby seems to have trouble when she tries to poo.

A: Babies do squirm and grunt and push when doing a poo without there being any discomfort – it doesn’t necessarily mean she’s constipated. Depending on how little ones are fed – it can for instance be normal for some breastfed babies to poo once a week, or a formula fed baby to open her bowels every few days – as long as the stool is passed fairly easily, it’s nothing to worry about.

You’re probably at the beginning of weaning your little one, and introducing fibre as part of her daily diet will keep her bowel healthy. Leave skins on most fruit and veg to add some roughage and offer plenty of water. Give her lots of opportunity to move around by playing on the floor, as this will help bowel function along too.

Q: My 3 month old’s nose seems to be constantly blocked. How can I help her?

A: Being narrow, babies’ nasal passages often sound snuffly as there’s not enough room for the mucus being produced. Snuffles may alarm you, but often won’t bother your baby. It can make feeding erratic though, as a baby will often need to have regular breaks, so offer extra, smaller feeds.

Other tricks to try are sitting your baby up when you can, raising the head of her cot using books under its feet and bringing her in the bathroom when the shower is on so the steam loosens nasal secretions.

To clear the nose, remove crusty bits with warm water and cotton wool. Tickling the end of the nose with cotton wool will encourage sneezing and help remove debris, but never stick anything into the nose. Saline drops from the chemist work for some little ones.

Q: My newborn has severe jaundice, which the doctors said was due to a blood group incompatibility. What causes this?

A: There are three main blood types – A, B and O. Babies inherit their blood type from both parents, so it’s possible for a mum and baby to have different types. With an ABO incompatibility, a mum makes antibodies against her baby’s blood group. Depending on the type of incompatibility, these antibodies can break down the baby’s red blood cells, causing anaemia and jaundice. Treatment is not always needed, but if it is, it’ll mean blood transfusions and phototherapy for the jaundice. The doctors and nurses looking after your baby can advise and support you. If you fall pregnant again, it’s essential that you receive early antenatal care to monitor you and your baby in case it happens again.