Your baby health worries answered by our GP

What immunisations can your baby have?

Make sure your little one's first shoes are fitted properly

Q: Are all the baby immunisations that we’re offered in the UK essential?

A: The risks to your baby of not having immunisations far outweigh the risks of having them. In the first few months of life, they’ll be offered immunisations to protect them against killers like diphtheria, tetanus and polio. Three of the newer immunisations – the meningococcus, pneumococcus and Hib vaccines – all protect against some of the most common causes of meningitis. Then, at just over a year, babies are offered immunisation against measles, mumps and rubella (German measles). Measles and mumps can both cause meningitis and permanent brain damage, or even death. German measles can cause terrible disabilities to babies if their mother catches it while she’s pregnant. To put perspective, measles still kills 8,000 children in developing countries every year - which country would you rather have your baby in?

Q: My 27-week-old baby started to eat solids at about week 23, but in the last seven days she has been refusing all food bar breast milk. I have cut down her feeds to four times a day so that she is hungry and I have tried finger foods, but she is just not interested. Help!

A: It’s common to run into weaning problems for a week or two. The fact that your daughter started off well makes it unlikely that there’s anything to worry about. As long as she’s having regular wet nappies, and is well in herself, the chances are that she’s getting enough nutrition. It’s especially important to make sure that she gets enough fluid – babies are much more prone to overheating than adults. Many children aren’t that interested in finger foods until they’re about eight months old. It’s worth waiting until she can sit easily on her own without support, and she’ll also find it easier when she has developed a pincer grip, so she can hold things between her thumb and fingers. If you’ve been giving her baby rice, how about mixing it with breast milk? That way, it’ll taste more familiar. Do make sure that any food is well puréed, too – you should be thinking about including some more textured food only from about eight months.

Q: According to my midwife, my baby has dilated kidneys. I’ve been told not to worry about it, but I can’t help thinking that I’ve done something wrong. What treatment will he or she need?

A: A dilated kidney or kidneys on the ultrasound scan is quite a common occurrence, and usually this doesn’t mean there’s anything to worry about. It’s generally only part of the kidney (called the pelvis of the kidney) that’s dilated, and it most certainly isn’t related to anything you’ve done wrong. As your pregnancy progresses, you’ll be offered regular scans to check how your baby, and his/her kidneys, are developing. There’s a good chance that you’ll be able to have a normal delivery, and that the only follow-up needed will be regular scans once your baby is born, and possibly antibiotics to prevent your baby from getting urine infections.

Q: I’m allergic to dairy and I am concerned that my new baby might inherit this. Will it be ok for me to feed him breast or formula milk?

A: Lots of people talk about being ‘allergic’ to dairy when they actually mean ‘intolerant’ of dairy products, or more usually lactose. True allergy, which is relatively rare, results in dramatic (sometimes life-threatening) symptoms if you are exposed to even the tiniest amount of dairy product. Lactose, or dairy, intolerance means that you get local symptoms, like diarrhoea and tummy pain, when you eat or drink a certain amount. In some people, this amount is quite small but others only get symptoms if they have large quantities.

Lactose intolerance is common in South Asians (95% of adults) and black adults (75%), but only about 10% of white adults ate intolerant. The intolerance develops in adulthood – it doesn’t affect babies – so if you’re dairy intolerant, your baby should be perfectly safe with formula milk as well as breast milk. If you’re truly allergic to dairy, there’s a slightly bigger chance that your baby would have problems with formula milk, but breastfeeding will pose no problems at all!

Q: When should my baby start wearing shoes? I’m worried about restricting growth but think he needs something substantial as he’s starting to stand up (with support!)

A: Don’t be tempted to put your baby into shoes too early. He’s developing at a dramatic rate during his first year, and it’s very important to let his bones grow straight. The bones in his feet and toes are very soft and even tight bootees or socks can cause problems. You should make sure there is space at the end of his socks or babygrow, both in length and width. You can also use soft ‘pram shoes’ but make sure these have lots of room.

Once your baby can walk, it’s essential to get his shoes fitted by a qualified fitter. And no matter how proud he is of them, reserve them for walking outside only.