Adults have kidneys competent to produce a concentrated urine , thereby making the urine small in quantity and rich in matter for excretion. A newborn, on the other hand, has kidneys that are rather immature in producing a concentrated urine. It follows logically that the urine amount shall be large and thus frequent too. By some 3-4 months he shall urinate less frequently . Till then – happy going !

In many newborns the scrotum may appear dark and larger than proportion. The fetus was exposed to maternal hormones while he was in the womb. The entire blood circulation and hormone status of the newborn gets independent of the mother soon as he is delivered. This appearance of the scrotum is because of this change and shall settle down in time.
Make sure , however , that there is no Hernia / Hydrocele ( HYPERLINK) / pain – redness – these shall be reasons enough to see your Pediatrician .

MY CHILD'S BREASTS HAVE ENLARGED SUDDENLY - WHAT DO I DO ?


This is known medically as Mastitis Neonatorum. 
This again is a transient hormonal adjustment from the maternal hormone levels while the child was in the womb ( MAKE A HYPERLINK TO " BLEEDING FROM THE VAGINA " AND "SCROTUM DARK AND LARGE" ) to the time that the child is now independent in his own hormonal status.

- Both boys and girls are equally likely to have it.
- This may persist for some weeks - perhaps even a month. Just leave it alone.
- Usually you shall find that the enlargement is not painful.

It is a common practice among some families ( especially with elders in the family or traditional massage - ladies visiting the child for the daily oil massage ) to squeeze out the " milk " in the breast. The belief is that it is " Witch's Milk ' and needs to be milked out for the health of the breast.

PLEASE DO NOT ALLOW IT. 

This practice of squeezing the breast tends to cause infection and further swelling in the breasts. The infection may get severe enough to require antibiotics and may cause significant misery to the child ( and to you too ).

MY CHILD PASSES A LOT OF GAS ( WIND ) : IS HIS DIGESTION UPSET ?

It is usual and common for young infants to be quite " gassy " and the parental reaction swings form amusement to worry.
During the act of sucking , the lips of the newborn are not closely wound round the nipple and he tends to take in air while he sucks.
This air fills the stomach - part of it gets expelled as a burp ( that is the reason, one always advises a proper burping after a feed ) and the rest goes down the intestine. It is this air that makes the child " gassy". 
No worry , nothing unusual …..no need to feel embarrassed either.
Burping him well shall reduce the tendency anyway.
 

I SEE SMALL RED PATCHES / SPOTS ON THE BODY - WHAT ARE THESE ?

These are known as Erythema Toxicum medically and in common parlance are known as Stork Bites.
You are likely to find them on the upper eyelids and perhaps a few on the face too.
These are transient skin changes and usually fade away within a week or so. Nothing needs to be done.
Of course , if you find yellowish or pus filled spots , you need to see your Pediatrician.

 

I SEE LARGER RED PATCHES / SPOTS ON THE BODY - WHAT ARE THESE ?

These again are transient skin changes and are known as Miliaria Rubra.
They may take the appearance of red pin head spots, mostly on the face and may then extend to the neck and the belly also. They may at times appear larger than pin heads.
Do nothing - wait for a week or so and they shall disappear on their own.

SOFTNESS IN THE CENTRE OF THE HEAD - THE CROWN - WHAT IS THIS ?

This is known medically as the Anterior Fontanelle.
The size is rather variable - from a 1 rupee coin size to twice or three times that much.
If the softness is at the level of the rest of the bony head , nothing needs to be taken care of. However , if you find that the softness is bulging above the level of the rest of the head, you need to see your Pediatrician immediately.
The head ( skull ) of a newborn is made of a loosely arranged set of bones and this softness is a gap in this loose arrangement. By the age of some 6-9 months it shall become smaller and should usually fill up completely by some 1.5 years. If you find it beyond this age , you may better see your Pediatrician.
You may also note that the softness pulsates gently ( an upward - downward movement). This is a normal phenomenon.

 

DO I NEED TO CLEAN THE TONGUE - HOW DO I DO IT ?

You do not , in the first place , need to clean the tongue. There will always be some milky deposit stuck onto the tongue - the more you try to clean it , the more the deposit will accumulate.
What best you can perhaps do is give him a sip of water after a feed to rinse his mouth ( if he is above 3-4 months of age - Pediatricians generally do not subscribe to water feed till 3-4 months age HYPERLINK TO " WHY DO PEDIATRICIANS DISCOURAGE WATER FEEDS ? )
 

MY CHILD SWEATS ON THE HEAD - ALMOST SOAKING THE PILLOW !

It is natural for the child to sweat on the forehead and you may usually find that he may even soak the pillow.
What may puzzle you is that this continues in cool weather / winters too.
There is no specific reason known to medicine why this happens - it is natural though.
Yes, in older children , sweating on the forehead is a symptom of Vitamin D deficiency. You may best meet your Pediatrician for him to decide between the two.
 

CRADLE CAP - WHAT IS IT ?

This is a brownish deposit of flaky material on the scalp, most abundant in the centre of the head. It is a usual feature for most children. 
In some it may actually be a fungal scalp condition known as Seborrhea Capitis ( akin to the dandruff you may be familiar with ). You may meet your Pediatrician and he shall help you out. He may offer some scalp lotion or shampoo for the Seborrhea Capitis.

 

MY CHILD VOMITS OUT / SPITS OUT MILK VERY FREQUENTLY - WHAT DO I DO ?

This is a fairly common complaint of mothers. You may find your child bringing up a small quantity of curdled milk or fluid milk rather frequently - may be at every feed.
Medically it is known as Regurgitation ( Possetting ).
You need to go into the background of the young infant's tummy and swallow process. The esophagus ( food pipe ) of older children and adults has a sphincter ( a kind of a one way valve ) at the lower end of the food pipe. This allows a one way traffic - allowing things to go in and not to let them come out. In young infants this sphincter is rather weak and allows a two way traffic !
With maturity of the system this traffic regulation shall get organized. Till then you shall have to contend yourself to some spillage of milk on your dress. One can almost make out a young infant's mother from the perpetually wet saree top and a moist blouse top ! 
You can reduce this by :

•  Burping your child immediately after a feed and burping him for longer

•  Feeding in the Madonna Position (head and shoulders up and the rest of the body
    sloping down ) 

•  Not laying him down on bed soon after a feed.

There may be some specific problem cases (which are best identified by your Pediatrician) in which this Regurgitation is actually because of what is known as Refluxing Esophagus. This condition is abnormal and needs treatment. You may best meet your Pediatrician and seek his specific advice.
 

MY CHILD'S HEAD ALWAYS APPEARS WARM - DOES HE HAVE FEVER ?

Infants will usually have a warm feel to their head and there is no specific medical explanation to it. In case you suspect he has fever , the correct thing to do is to record his armpit temperature . In case he does have recorded fever , you need to see your Pediatrician. A simply " warm head" is no need for you to disturb your sleep over.

MY NEWBORN IS JUST A FEW DAYS OLD AND HAS YELLOW EYES - THEY SAY IT IS " JAUNDICE " - WHAT DO I DO ?

Please see  JAUNDICE IN NEWBORNS

MY CHILD HAS A DISCHARGE AT HIS NAVEL - WHAT DO I DO ?

The discharge could be one of these types :

• Watery, clear and scanty in amount : nothing specific needs to be done - just wipe with some surgical spirit a few times a day.

• Yellowish , somewhat smelly : This is something one does not like to have. This may indicate an umbilical infection ( Omphalitis) and this may, at times ,lead to a fairly serious blood infection of the child. Start cleaning the cord with surgical spirit and apply some readily available dusting powder 
  ( e.g. Soframycin or Betadine Dusting Powder) and fix up with your Pediatrician immediately.

• Watery with some element of blood to it : This is basically the crust of the dried cord coming off and needs to just be cleaned with surgical spirit.

• A persistent discharge that is not getting okay for several weeks - months : This may indicate what is medically known as Patent Vitello Intestinal Duct and you need to fix up with your Pediatrician. He may ask you to see a Pediatric Surgeon and they together may approach the problem.

MY CHILD HAS A TINY , FLESHY GROWTH AT THE NAVEL AND THERE IS SOME DISCHARGE ALSO - WHAT IS THIS ?

This may be what is known medically as Umbilical Granuloma or Umbilical Polyp. 
Keep cleaning with surgical spirit and meet your Pediatrician . He shall be helpful in deciding between the two and guide you accordingly.

WHEN DO I EXPECT THE CORD TO SHED OFF-WHAT DO I DO AFTER IT HAS SHED ?

Usually it would shed off anytime between 7 - 10 days. This is quite variable - in summers it tends to shed off somewhat earlier than in winters (dependent on cord drying).
A few days here and there do not really matter and one is yet to see a child who needs any specific intervention for a delayed cord shedding !

MY CHILD HAS A PROLONGED EYE DISCHARGE - WHAT DO I DO ?

A discharge from the eyes on newborns is a fairly common issue. It often sets the mother worrying since a variety of eye drops have already been tried and the discharge just goes on and on.
A brief background of the functioning of a normal eye is what may help you. Every time one blinks one's eye , the natural tears formed inside the eyes ( to keep them moist and lustrous) move down into the throat through a small hole in the eyelid. There is a narrow passage from this hole that goes to the throat ( Naso Lacrimal Duct ) . What is happening in your child with his persistent eye discharge is now simple to understand. The hole is poorly developed or the passage is not very efficient in draining the tears . Consequently there is a pooling of these tears , which you see as a discharge.
Eye drops shall not help much. What you need to do instead is a massage on the Naso Lacrimal Duct. You need to cut your nails short. A gentle round about motion at the area where the eyes meet the nose bridge followed by slipping down the fingers along the crease of the nose with the face. This massage may be done as many times a day as is possible. It can never be too much. It may take a few weeks to a month or even more for the drainage to get okay and for the discharge to stop. 
In case it persists still, your Pediatrician may fix you up with an Ophthalmologist ( Eye Surgeon) who may think about a small procedure for opening up the drainage route.

MY NEWBORN KEEPS HIS EYES CLOSED MOST OF THE TIME - IS IT NORMAL?

The child has been in absolute darkness for some 9 months and his eyes' retina is not accustomed to the bright lights that he is coming to terms with.
You may notice that in dim light , he shall blink his eyes open and shut a few times till he settles down to open eyes. His eyes are judging the ambient light like the photometer of a camera does. Keep the lights dim and enjoy seeing his eyes !

MY NEWBORN'S EYES APPEAR UNEQUAL IN SIZE-IS THERE SOMETHING WRONG ?

It is usual for the eyes to appear unequal in size during the first few weeks.
Please see " MY CHILD KEEPS HIS EYES CLOSED MOST OF THE TIME "

MY INFANT'S EYES APPEAR TO HAVE A SQUINT - WHAT DO I DO ?

It is common for some infants to be having a squint ( misdirected eyeballs ). 
Interestingly, the squint may not be noticed by you. Instead some visitor or neighbor may generally drop in the hint ( embarrassing as it is to talk about squints ! ).
The internal eye muscles that regulate the fine movements of the eyeballs are often immature in some infants and lead to a squint. This should usually pass off by some 2 years of age. It is a good idea to show your local Pediatrician anyway.

WHAT IS BEST FOR CLEARING A NOSE BLOCK ?

The market is flooded with several prescribed and Over The Counter medicines for clearing nose blocks. They are effective and prompt in action and you may feel tempted to reach out for them.
While these medicated drops are effective , they have the troublesome side effect of " Rebound Congestion " ( the block gets back and gets back with a vengeance ). Prolonged use is harmful to the delicate mucosa of the nostrils.
The simplest solution is Normal Saline Nose Drops ( available at medical stores with several trade names ).Use them liberally and for as long as you feel the need. Your mother might snigger at you for the purchase of these drops - since she has brought you up on salt-water as a blocked nose remedy. Normal Saline is just this - it is ordinary water with a pinch of salt !
Please do NOT try using cotton buds. This shall push the block further deep, adding to the misery.

HOW DO I CLEAN MY INFANT'S EARS ?

The easiest way is not to attempt to clean it at all !
If you have tried - you would know just how difficult it is. The most you can achieve is to clear the external ear canal with some cotton buds. Do not try to go any deeper - the misadventure can be dangerous.

THE LEGS APPEAR CURVED - IS IT NORMAL ?

A relative curvature akin to slight bow-legs is normal and almost universal in all infants. Usually the legs shall achieve their proper curvature by some 1.5 - 2 years. 
Your local Pediatrician, however, would be the best judge as to the degree of curvature.
For sure, a definite curvature ( Bow Legs ) beyond the age of 1.5 - 2 years may be indicative of Vitamin D Deficiency ( Rickets ) and you need to consult your Pediatrician.

SMALL " BOIL ON THE UPPER LIP- IS IT NORMAL ?

You might notice a small " boil " like appearance at the upper lip right in the center.
This is a usual and normal feature and is caused by the sucking action of the newborn. It shall pass off in some months.

SMALL " BOILS " INSIDE THE MOUTH - ON THE UPPER SURFACE OF THE PALATE - IS IT NORMAL ?

You may note a couple of white pearly boils deep in the mouth on the upper surface of the roof of the mouth ( known as the Palate ). These are glandular deposits and almost every infant has these. They are of no medical consequence and shall dissolve spontaneously.

HEAD SHAPE IS NOT UNIFORM " ROUNDED " - APPEARS DEFORMED !

The skull is made of several thin, curved bones which unite loosely at what is known as " suture lines of the skull" . This union is loose and ill defined. As a consequence of this, the head may not appear to have the " perfect and pretty round " you may like it to be !
You may also note a " dent" either on the left or the right side of the back of the skull.
All these are temporary and the head shall acquire its well rounded shape by the age of some 1.5 - 2 years when the skull ripens.

KEEPS HEAD TILTED TO ONE SIDE - IS IT NORMAL ?

You might note that the infant has a preference in head positioning and you may find the neck / head usually tilted to either side.
This again is a normal and usual phenomenon and time shall take care.

SKIN IS DRY AND HAS MINOR CUTS - WHAT TO DO ?

In many newborns the skin may appear dry and you may find minor cuts and abrasions , especially at the creases.
This is usual especially in Post Dated deliveries ( child born after the due date ) and is due to the skin having suffered some nutrition because of stay in the womb longer than nature intended.
Do nothing except applying some extra oil or baby cream and wait for some days or weeks.