Good Baby TipsTips for keeping your baby happy and healthy

Diaper rash is the most common kind of skin inflammation (dermatitis) that infants face. Every baby has it at one time or another. But fortunately, it is rarely a serious condition and can easily be treated at home. Do not get worried if your baby develops diaper rash but do not treat it lightly either. Take immediate measures for its treatment.

How would I know my baby has diaper rash?

Diaper rash mostly appears in the diaper area. Your baby has diaper rash if he has mild redness and scaling on or around his buttocks, thighs and genitals. In a more severe case of rash pimples, blisters and sores can also form. If the rash gets infected the skin might become bright red and swollen. If it is still left untreated, the rash might start to spread even beyond the diaper area. If your baby’s skin looks like any of these, he has diaper rash.

Another symptom of diaper rash is that part of the diaper area affected by the rash gets slightly warmer. The baby also becomes very uncomfortable, especially during diaper changes. He also cries and makes a lot of fuss while the diaper area is being washed or touched.

What causes diaper rash?

There are several causes of diaper rash as the diaper area is the most suitable damp and dark area for rash to develop. The causes of the rash vary which is why sometimes its treatment fails. The major causes of diaper rash are as follows:

• Irritation: The most common cause of diaper rash is simple skin irritation. The baby’s skin is much more sensitive than an adult’s and is very prone to irritation. This irritation can be caused by the rubbing of the diaper against his skin if it is fit too tightly. It can also be caused if the baby is left in a wet pamper for too long. The prolonged exposure to ammonia and moisture can cause irritation and make the skin look red. A baby is more prone to diaper rash if he has frequent bowel movements as stool is more irritating than urine. You can know that your baby has a simple case of irritation if the diaper area is red but the folds of skin, a more protected part, are not red.

Other than this, irritation can also be caused by any new product that you introduce to your baby. Sometimes some new brand of wipes or diapers does not suit his skin. At other times it could also be a new soap, detergent or bleach that you use to wash his cloth diapers. Diaper rash can also be caused by some ingredients in baby powders, lotions and oils.

• Changes in Diet: Sometimes babies can also develop diaper rash when solids are introduced in their diet. Solids can change the constituents of the stool or lead to more frequent bowel movements, both eventually causing diaper rash. If a baby is breast-fed his diaper rash could also be a response to something in the mother’s diet.

• Use of Antibiotics: Sometimes when antibiotics are used to kill bacteria causing diaper rash a balance is not maintained. This imbalance can worsen the rash. If a child is breast-fed, the mother’s use of antibiotics can also cause him diaper rash.

• Bacterial or Yeast Infection: A mild diaper rash can grow and spread to areas outside the diaper too. The damp and moist area of the diaper is most suitable for the growth of germs, bacteria and yeast. Once the rash gets infected by yeast it becomes bright red and pimply. A bacterial or yeast infection can be differentiated from a mild irritation rash as it is present even in the folds of the baby’s skin where irritation rash is not.

• Plastic Pants: Rash can also be caused by plastic pants that tightly fit over diapers. These pants raise the heat and moisture level in the diaper area, making it a more suitable place for diaper rash to start and germs to grow.

How do I control and prevent diaper rash?

The most important factor in aiding the healing of diaper rash is to keep your baby’s diaper area clean, cool and dry. Practice the following healing and preventive measures to reduce the chance of your baby developing rash.

• Change Diapers Promptly: Keep checking your baby’s diaper frequently and change it as soon as it gets wet so that his skin is not exposed to the moisture and ammonia for a long time.

• Clean the Diaper Area: Whenever you change his diaper make sure to clean the diaper area well. Use plain, not hot water, with or without a mild perfume-free soap. Do not use wipes that contain alcohol or fragrance and make sure the baby’s diaper are is completely dry before putting on a new diaper. Do not scrub his bottom with a towel. Scrubbing can irritate the skin. Pat him dry or leave to air-dry.

• Air-time: Giving your baby some diaper-free time always helps with rash. The most appropriate time, when there is least chance of messy incidents, is right after his bowel movement.  You can also lay him on a big towel and engage in playing with him while he is bare-bottomed.

• Avoiding Plastic: Rash can also be caused by over tightening the diaper. Keep it a little loose so that the diaper area can breathe. You can also use a larger sized diaper for this purpose. Avoid using diapers with plastic edges or plastic pants that fit over diapers as they trap in the heat and moisture.

• Washing Cloth Diapers Thoroughly: If you are using cloth diapers, washing them thoroughly and keeping them clean is very important. Soak heavily soiled cloth diapers before washing them and use hot water to wash them. Use a mild detergent and skip fabric softeners as they may contain fragrances that could irritate your baby’s skin. Double rinse your baby’s diapers if he already has a diaper rash or is prone to developing diaper rash. You can also put half a cup of vinegar in the rinse cycle to get rid of alkaline irritants.

• Creams & Ointments: Use creams with zinc-oxide and petroleum at every diaper change to keep the moisture from reaching your baby’s skin. Some steroid creams can also be used but never apply them without consultation with a doctor.

• Wash Your Hands Thoroughly: After changing your baby’s diaper, wash your hands thoroughly every time to avoid the spreading of bacteria to other parts of the baby’s body or to your other children.

• Avoid Cornstarch or Talcum-powder: Both these products are not recommended for diaper rash. Talcum powder can get into the baby’s lungs and cornstarch makes a yeast infected rash worse.

When do I call the doctor?

Diaper rash is usually not a serious condition and it can be treated by following the simple home remedies suggested above. However, sometimes the diaper rash gets worse or persists for longer and you need to consult with a doctor. If your baby has the following symptoms, he needs professional medical attention. Do not delay taking him to see your pediatrician.

• The rash has appeared on the baby’s skin in the first six weeks.
• The rash seems to be infected.
• Pimples and small ulcers are formed.
• The baby is suffering from fever.
• The baby isn’t eating as he usually does or appears to be losing weight.
• The rash spreads to areas outside the diaper, such as arms, face or scalp.
• The rash persists for more than one week even though you have tried the home remedies listed above.

Cloth diapers or disposable diapers?

Parents often have this question, whether they should use cloth or disposable diapers. As far as diaper rash is concerned, there is no convincing evidence in favor of either. Some doctors suggest that cloth diapers are better as they do not hold too much moisture and allow more air to pass. Some suggest that disposable diapers are better as they are more absorbent and keep the baby’s skin drier. So it is a parent’s call which kind to use. If you use disposable diapers make sure to check if that brand suits your baby. Change and try another if a certain brand doesn’t seem to work out. If you use cloth diapers make sure to wash and clean them thoroughly as suggested earlier.

In both cases, the most important thing is that you check your baby’s diaper frequently and change it as soon as it gets wet and keep the baby’s bottom as clean and as dry as possible.

Heat rash is a mild skin condition often suffered by babies when they get over heated. It is also known as prickly heat or miliaria. Parents often worry if their child is in pain because of heat rash. It is not a serious condition and not painful but it can get very itchy if proper measures are not taken. Even though the condition is not serious itself it is an indicator of the fact that your child’s body is too hot. If you do not take immediate action to cool him down, other more serious conditions like heat exhaustion, heat stroke or dehydration might take place.

What is heat rash?

Heat rash appears on a baby’s skin as hundreds of tiny pink or red eruptions, each surrounding a pore. Sometimes they resemble tiny water blisters. The rash usually occurs on the baby’s cheeks, neck, shoulders, skin creases, diaper area and wherever clothes fit him snuggly. Although heat rash is more common is hot and humid climate, it can also occur in cold weather if the child is over heated due to heavy clothing.

How is heat rash caused?

Heat rash is caused by excessive sweating and a hindrance in the passage of that sweat out of the skin. The sweat glands normally release sweat through the duct onto the skin’s surface. When perspiration cannot reach the skin’s surface because of folds of skin or tight clothing, the sweat may break through the walls of the ducts and become trapped inside the internal layer of skin, causing inflammation. This is known as heat rash. Babies and younger children are more likely to get heat rash because their sweat glands are not fully developed yet.

How can heat rash be treated?

Most heat rashes clear up themselves in a few days. If it persists for longer, seems to be getting worse and is not responding to medicine, consult you baby’s doctor. Usually the baby can be relieved of the rash in the following methods:

• Avoid heat: Foremost, it is important to get rid of what causes the rash; heat. Move to a more airy place if you are indoors. In outdoor areas look for a cooler and shadier place and try to get the child some rest time if the rash is being caused by him running around in a hot and humid weather.
• Avoid heavy clothing: If a baby starts to get very hot and develops heat rash remove his clothing if possible. If not then dress him in lighter clothes. Always opt for cotton and natural fibers instead of nylon or polyester which trap heat. When a baby has developed heat rash try to give him as much nappy-free time as possible.
• Keeping the skin cool: To directly cool the affected area of the baby’s skin give the baby a cool bath. After a bath, let the skin air-dry and do not use towels, they can cause friction and irritation with the rash. Like a little nappy-free time, allowing the child some nude time also quickens the healing process.
• Applying cream: Use calamine lotion directly on the baby’s skin taking special care to avoid the eyes. You can also use a hydrocortisone cream if your doctor advises so for a severe rash. Avoid using any other cream or lotion on the baby’s skin as it traps moisture and makes the rash worse.

Some important things to remember about heat rash are that when adopting the above ways to cool down your baby’s body temperature, keep an eye out for it. The baby might get chilly and need to be warmed up again. To avoid heat rash, make sure your child is wearing light clothes whenever you venture outdoors in a hot and humid climate. Clean the sweat prone areas with wet wipes to avoid clogging of the pores by excessive sweat. Heat rash can also be caused by fever. If your baby has fever, in addition to following these above steps investigate into and treat the baby’s fever which is the real cause of the rash. Remember, heat rash is caused by fever but fever is not caused by heat rash.

What is Cradle Cap?

Cradle Cap is harmless; this is the first thing you should know about it. It is aesthetically displeasing but usually harmless for the baby until it aggravates to a degree that it looks red and swollen, then it may cause itching.

Cradle Cap is a condition of the skin. The human skin is always producing new cells and shedding off old ones, a process that we do not notice. Babies suffering from Cradle Cap have hyperactive seborrheic glands that are responsible for producing oil. Their skin produces new cells at a faster rate than it sheds them, which results in flaky or dry skin that looks like dandruff, or thick, oily, yellow/brown scaling or patches on the head.

Sometimes this skin condition can also occur on other parts of the baby’s body, for example around the ears and eyebrows and creases like armpits or even the diaper area. Then this condition is known as seborrheic dermatitis as it occurs where there is the greatest number of oil-producing sebaceous glands.

Why does Cradle Cap occur?

Cradle Cap can occur in any baby, there are no risk factors that make one baby more prone to it than the other. It usually occurs in the first six weeks of the baby’s life and usually continues up till three months of age. Most often Cradle Cap resolves itself and no treatment is required. However, in some cases the condition may prolong to several months or beyond.

The exact reason for the occurrence of Cradle Cap is not agreed upon. The most common consensus is on the opinion that it is caused by hormones passed from the mother to the baby, through the placenta, just before birth. These hormones are thought to over stimulate the seborrheic glands, producing more oils and making scaly patches appear over the skin.

Cradle Cap is not infectious or contagious. Some suggest that it is an allergic reaction or is caused by poor hygiene; however, both these views are wrong. Cradle Cap can occur in any baby and mostly goes away itself.

How do I treat my baby’s Cradle Cap?

No treatment is really required for Cradle Cap, it goes away by itself. However, it is unpleasing for parents to see their baby’s skin like that. If it bothers them, they could try to shampooing regularly with a mild shampoo and brushing the baby’s scalp with a soft brush or terry cloth. Don’t be afraid to shampoo the baby’s hair, in fact it should be done more frequently, about 2-3 times a week.

For more persistent cases of Cradle Cap, sometime the oil treatment is helpful. However, it is important to know that oil helps to build scales by clogging the pores and allowing the scales to stick, if used in a large amount or allowed to stay on the scalp. If oil is being used, use a small amount. Rub it into the baby’s scalp; leave it on for a few minutes (it will help to loosen the scales) and then comb out the scales gently with a soft brush or tooth-comb. Be sure to shampoo the baby’s head afterwards so that the oil does not stay in.

For even more persistent cases that are not resolved by oil or shampoo, doctors may suggest stronger medicated shampoos. But do not use an antiseborrhea without consulting your pediatrician first as these shampoos contain small amounts of sulfur and salicylic acid and may cause irritation to the baby. The doctor may prescribe some other lotions or creams to treat the redness and scales.

Can I prevent Cradle Cap from coming back again?

If the Cradle Cap has completely disappeared, it is unlikely to come back again. If your child is a year old it rarely comes back before puberty. However, preventive measures include washing the baby’s hair frequently, about two to three times a week. Take care not to over do it as it may stimulate the oil glands and produce more oil.

If the condition keeps persisting off and on and does not finish completely you might need to keep using antiseborrhea shampoos in frequent intervals. However, consult your pediatrician before any such step and let him/her decide if your baby still needs those shampoos or lotions.

SIDS, Sudden Infant Death Syndrome, as the name suggests, is the unexpected death of a baby less than 1 year of age without an apparent cause of death. The exact cause of SIDS remains unknown even after years of research. The mystery attached to SIDS and its causes is what makes it so frightening for parents. There are no answers to their questions, only theories and conjectures. The death of an infant is always tragic for parents, however, the death of a baby due to SIDS, without any symptoms of ailment or time for parents to prepare themselves for what is to come, can be extremely traumatic. SIDS has claimed the lives of infants since the beginning of the human race. It is still the leading cause of death amongst children from 2-6 months. No definite causes of SIDS are known but there are many precautionary measures that are recommended to parents to reduce the risk of SIDS. However, sometimes SIDS occurs even when all possible measures have been taken.

SIDS can occur in children from all races, socio-economic and ethnic backgrounds from urban and rural areas. Its likelihood is not determined by any factor accept adherence to the precautionary measures suggested by doctors and researchers. There are no symptoms of SIDS. It occurs in healthy babies who feed normally. SIDS mostly occurs during sleep which is why it is also known as Cot or Crib death and the baby shows no signs of suffering. SIDS has only recently been established as a separate disease entity and can be given as an official cause of death. If the child’s death remains unexplained even after a formal investigation into the circumstances of death (including performance of a complete autopsy, examination of the death scene, and review of the clinical history), the death is then attributed to SIDS.

Possible Causes of SIDS:

• Sleeping on Stomach: The most widely accepted cause of SIDS is putting the baby to sleep on his stomach. Numerous studies and researches conclude that most SIDS deaths have occurred in babies who sleep on their stomachs. It was formerly thought that babies should be put to sleep on their stomach as they rest better and sleep more soundly in that position. However, after research results have shown that stomach sleeping increases the risk of SIDS, parents are advised against it.According to researchers’ hypothesis stomach sleeping puts pressure on the baby’s jaws that hampers breathing by narrowing the airway.

  Another theory suggests that stomach sleeping can increase an infant’s chances of re-breathing his own exhaled air, particularly if he is sleeping on a soft mattress or with bedding, stuffed toys, or a pillow near his face. These soft surfaces can create a small enclosure around the baby’s mouth and trap exhaled air. As the baby breathes exhaled air, the oxygen level in the body drops and carbon dioxide accumulates. This lack of oxygen can contribute to SIDS. (Click for source)

• Abnormality in the Arcuate Nucleus: Infants who have some kind of a breathing disorder might be more likely to succumb to SIDS. For example, they may have an abnormality in the arcuate nucleus, a part of the brain that may help control breathing and awakening during sleep. If a baby is breathing stale air and not getting enough oxygen, the brain usually alarms the baby to wake up and cry. That movement changes the breathing and heart rate, making up for the lack of oxygen. But a problem with the arcuate nucleus could deprive the baby of this involuntary reaction and put him at greater risk for SIDS.
  (ibid.)
• Apnea (lack/cessation of breathing): Many young infants have an uneven breathing pattern. Some even have periods, known as apneic episodes, when they do not take a breath for up to 20 seconds or longer. One theory of SIDS suggests that for some babies, the respiratory system is so underdeveloped that they do not take a breath after an apneic episode. Infants with apnea may be monitored with electronic monitors prescribed by doctors that track heart rate and respiratory activity, though these monitors cannot prevent SIDS. Prolonged apnea may put a baby on a greater risk of SIDS but most apneic babies do not die of SIDS and most SIDS babies do not have apnea.
• Choking: Sometimes regurgitated food is found in the mouth or nasal passage of a baby who has died of SIDS. In these cases physicians or investigators believe that choking on these substances was the cause of SIDS. However, vomiting frequently occurs at the time of death. So these findings might not be the cause of death but its result.
• Allergy: An allergy, especially to cow’s milk, was also once thought to be a cause of SIDS. As SIDS mostly occurs in babies from 2-6 months (a time when they are gradually being weaned from the breast to the bottle) cow’s milk was thought to be the culprit. However, research shows that babies who have been breast-fed exclusively also die of SIDS. Breast feeding however may help to prevent infections that could possibly lead to SIDS.
• Smoking: Studies show that a baby’s risk of SIDS rises if he is exposed to second hand smoke. Each additional smoker in the household, the number of cigarettes smoked around him each day, and the length of his exposure to cigarette smoke, all contribute to a possible SIDS death.
• Premature Birth or Low Birth Weight: Babies who are born prematurely or those who have a lower birth rate are also at a higher risk of SIDS.
• Overheating while Sleeping: Research shows strong evidence that overheating by too much clothing, putting a blanket over the baby’s head or overheating the room can substantially raise the risk of a SIDS death.
• Suffering an Apparent Life Threatening Event (ALTE): It is also thought that babies who suffer apparently life threatening events such as abrupt changes in breathing, color and muscle tone and requiring resuscitation are at a greater risk of SIDS. However, no definite scientific evidence links ALTEs as events that may lead to SIDS.
• For Mothers: SIDS is not hereditary, however babies are at a higher risk of SIDS death if the mother:
  • Has had inadequate parental care
  • Is younger than 20 years
  • Has had low weight gain during pregnancy
  • Has smoked or used drugs during pregnancy
  • Has had placental abnormalities — such as ‘placenta previa,’ a condition where the placenta lies low in the uterus, sometimes covering the opening of the cervix. (click for source)

Measures That Can be Taken to Reduce the Risk of SIDS:

Although SIDS can occur without any known reason and besides taking preventive measures, based on research and the possible causes of SIDS, following are measures that can reduce the risk of its occurrence.

• Back Sleeping: Researchers have claimed that putting the baby to sleep on his stomach is the most likely cause of SIDS. Since then the American Academy of Pediatrics (AAP) has included putting a baby to sleep on his back in its guidelines. Some parents worry that sleeping on the back might cause their baby to choke on spit-up or vomit. However, according to AAP, healthy babies are at no more risk of chocking on their backs than they are on their stomachs. If your baby has chronic gastroesophageal reflux disease [GERD] or certain upper airway malformations, consult your doctor about the best position for your baby to sleep. It might be a better idea to put such babies to sleep on their stomachs.If you are worried about the baby spending too much time on his back and developing a problem because of that, allow the baby more ‘tummy time’ when he is awake. When babies learn to roll over it might become difficult to keep them on their back all night. At this stage the baby is already 4-7 months and it is quite alright to let him decide a sleeping position for himself.
• Good Prenatal Care: Take good care of yourself and your baby during pregnancy. Have regular checkups to ensure normal weight gain and baby growth. After delivery, have your baby checked up regularly, especially if he is premature or had a low birth weight.
• Avoid Smoking: Avoid smoking, drinking and using drugs during pregnancy. Babies born to mothers who have smoked during pregnancy are thrice more likely to die of SIDS than those whose mothers have not smoked. It is thought that smoke affects a baby’s nervous system. Avoid a baby’s exposure to second hand smoke as it doubles the risk of SIDS. Do not allow people to smoke around your child.
• Prevent Suffocation and Overheating: Make sure the baby is not over heated when sleeping. Make sure to keep the baby’s head exposed while sleeping. Keep a room temperature that feels comfortable for an adult in short sleeves. Being too warm while sleeping makes babies go into a deeper sleep which is hard to arouse from.
  Always put your baby to sleep on a firm mattress, never on a pillow, waterbed, sheep skin or other soft surfaces. Do not place quilts, blankets, stuff toys and pillows near the baby as these may lead to suffocation and re-breathing of stale air.
• In case of GERD: If your baby has GERD, consult your doctor about his sleeping and feeding positions.
• Using a Pacifier: In the first few months of his life, put your baby to sleep with a pacifier. Research has linked pacifiers with lower risk of SIDS. Start giving him a pacifier after the first month so that he establishes breast feeding and the pacifier does not hinder with it. However, if your baby rejects a dummy, do not force him to take it.
• Safety Measures for Co-Sleep: Whether to sleep with the baby in the same bed or put him in a crib or bassinet, is still debated. In biblical times SIDS was known as ‘overlaying’ (because it was thought the mother had lain atop the baby while sleeping.) This surely is a risk if you sleep with your baby (sometimes called co-sleeping) so it is a good idea to put a baby in his crib when he is about to sleep. The cribs or bassinets should be in the parent’s room so that they can keep checking on the baby regularly. The parents’ bed also contains soft beddings, cushions and pillows, all that can lead to suffocation. There is a higher risk of overheating with the quilts and blankets and the presence of the mother.But, on the other hand, some people are of the opinion that babies should sleep with mothers in their beds. This allows the mother to respond quickly to any movement or change in their breathing patterns.

  The choice is to be made by the mother. If she decides to take her baby to bed there are a number of things she should keep in mind. The mattress should be firm and flat, tightly fit against the headboard leaving no gaps. There should be no fluffy pillows or heavy bedding that can cause breathing problems for the child. And the baby should be put to sleep on his back.

Why are the Causes of SIDS Unknown?

The efforts to determine the causes of SIDS are greatly hampered by underreporting and misreporting of SIDS deaths. As SIDS has no symptoms its cause can only be investigated into after the death has occured. This requires an autopsy, which, in many places of the world, requires parental permission. Many parents do not agree to it and the death may be registered due to some other cause. Even if the autopsy is carried out different children, from different areas of the world, have different reports. This lack on inconsistency makes it very hard to determine the cause of SIDS. The parents of SIDS babies, often victims of guilt and self-blame, also think of reasons for their child’s death to console themselves. Absolute absence of answers can be unacceptable. Thus SIDS can be registered as a death caused by the reason imagined by the parents.

Dealing with SIDS:

Parents of a SIDS baby suffer a great loss. Unlike parents of a baby who suffers from a disease, parents of a SIDS baby are taken aback by the suddenness of the death and do not have any warning or time to emotionally prepare themselves. Not only the parents, other caregivers such as grandparents, a baby sitter and the baby’s siblings (especially if they are old enough to help with taking care of him and have developed a special bond) suffer too. Their loss is often overlooked while focusing on the parents only.

In face of such a loss the bereaved parents usually experience feelings of guilt, anger, fear, blame and despair. As the causes of SIDS are unknown, parents often come up with their own explanations for the tragedy and blame themselves. This is a very common reaction; however, it is important to keep in mind that SIDS is not the parents’ fault. Besides taking the preventive measures there is nothing they can do to prevent it.

SIDS can affect a marital relationship and family life in general. It is good to talk to others about your feelings instead of bottling them up. There are support groups available for parents and families who have suffered from a SIDS death. You can also consider counseling or talking to other parents who have been through the same experience. However, the best support always comes from one’s own friends and family.

What really is colic?

Colic is a very broad and commonly used term by different people in different ways. It is a condition mainly described by symptoms rather than a physiological explanation of what it is. In the 1950s, Dr. Morris Wessel, a well-known New Haven pediatrician, defined an infant with colic as “one who, otherwise healthy and well-fed, had paroxysms of irritability, fussing or crying lasting for a total of three hours a day and occurring on more than three days in any one week for a period of three weeks.” (click for source) Colic crying is often scheduled and happens around late afternoon or early evening. It starts when the baby is about two to four weeks old and usually ends in about three months of age (in some unusual cases it might extend beyond up till six months.) For your baby to be colic it is important that he is otherwise well-fed and healthy. If he has any other medical condition, he might be crying because of that. Before pursuing any treatment for colic, it is important to make sure that your baby is in fact colic.

Symptoms of Colicky Babies:

As colic is a condition primarily described only by its symptoms, it is helpful to keep an eye out for them. Each baby has different symptoms of colic, some exhibit only one while others may show a number of them.

• Colic is not a serious condition. Colicky babies continue to gain weight normally and have no permanent marks on their development because of it. However, it can be difficult on the parents’ nerves to handle a colic baby’s constant crying. A colic baby seems to be in pain which he might exhibit by becoming red in the face, clenching his fists, drawing his legs up to his stomach and then fully stretching them.
• Some colic babies refuse to eat or become very fussy soon after the feed.
• A colicky baby may also lift his head and legs and pass gas.
• Colicky babies might also experience fussiness, irritability, difficulty in sleeping and staying asleep.
• Colicky babies show signs of gas discomfort and abdominal bloating. Their stomachs often become hard and distended.

Colicky crying, but why?

As mentioned, the major characteristic for colic is uncontrollable, extended crying, but due to what? As there is disagreement about what colic really is, there is a lot of difference in opinions about its causes.

• Gastrointestinal discomfort: Most commonly, colic is associated with gastrointestinal discomfort as ‘colic’ comes from ‘colon.’ In the first three months of his life, the baby’s digestive system is still immature and developing till the age of three months. It has not yet developed the bacteria that aids digestion and is only learning to function. Therefore, it experiences spasms that cause colic.
• Immature nervous system: Another suggested cause for colic is a weak nervous system and a tendency of the baby towards general irritability. The baby, with an immature and developing nervous system, gets tensed up due to any external stimulation. Some babies are more sensitive in nature than others (just like adults) and react more to their surroundings. These babies are more prone to crying and becoming irritated due to some sudden change in the environment.  Sometimes it is also believed the colic can arise due to transmission of anxiety and stress from the parents to the baby.
• The baby’s milk: Sometimes colic is also linked to the baby’s milk, whichever he may be taking, breast or bottle. For breast milk, in a few cases, the diet the mother is taking, if it contains volatile chemicals, allergens or other gas producing foods, it may be passed to the infant. For bottle fed babies intolerance for cow milk is sometimes supposed to be the reason for colic.
• Swallowing Air: Babies also swallow air when they are feeding or strenuously crying. This builds up an air bubble that adds to the bloating and discomfort. It is a vicious cycle, the more the baby cries of colic, the more air he swallows and increases his discomfort.
• Crying triggering more crying: It is also thought possible that the baby’s own crying triggers colic crying in the same way a baby is startled by his own startle reflex.
• Gastroesophageal reflux disease (GERD): In some cases it is also suggested that colic is being caused because of undiagnosed GERD. This makes the baby vomit or become fussy after feeding.

All these causes of colic given above are conjectures and debated upon. Several researches have been conducted upon the causes of colic, producing supporting and contradictory results for each of the above causes. These reasons might or might not be the reason your baby has long spells of crying. As the causes of colic are not definitely agreed upon, there is no guaranteed treatment. Treating the colic is basically making the baby and the mother as comfortable as possible.

Treatment of Colic:

Before consulting your doctor for treatment of colic or concluding that your baby is in fact colicky and trying some home remedies, check for the following. These may be things other than colic that might be making your baby cry:

• Is your baby hungry?
• Is he tired and sleepy?
• Is he wet? Is it time to change his diaper?
• Is there a lack of contact between the mother and baby? Some babies want to be cuddled all the time
• Does the baby startle due to jerky movements or sudden noise?
• Is his body temperature normal? He may be too hot or too cold.
• Is he in pain because of something else? For example an open nappy pin or rash?
• Check with your baby’s doctor for other illnesses like fever, vomiting, cough etc.

If you are sure that your baby is not crying for any of the above reasons, then perhaps he is colic. There is no set treatment of colic; different babies are comforted in different ways. Perhaps one of the following might work for you:

• Avoid overfeeding: Do not over feed your baby in order to make him stop crying. If he is bottle-fed do not urge him to finish his formula. Over feeding may cause gas and stomach aches.
• Reduce amount of air: If your baby is bottle-fed, check the size of the nipple. If it is too big or too small, the baby might be taking in more air than he needs. Also try using a curved bottle or a bottle with collapsible disposable liners. The aim is to reduce the amount of air being swallowed by the baby.
• Switching Formulas: In bottle-fed babies allergies to cow’s milk or soy formulas have also been thought to cause colic. Consult your doctor and if he recommends, try switching to a different formula.
• Changes in a mother’s diet: For breast fed babies there might be something in the mother’s diet causing the colic. Check with your baby’s doctor and with his consultation drop onions, cabbage, cauliflower, spicy foods, caffeine, beans or other gas producing foods from your diet. Eliminating dairy from your diet might also be helpful although you should always check with the doctor. He might not recommend it or give you some calcium supplements.
• Regular Burping: Make sure to burp your baby after every feed to avoid the build up of an air bubble.
• A peaceful environment: When the baby is having a crying episode, take him to a place that is less noisy. Bright lights, a lot of activity, a large number of people around, fatigue and over stimulation, may make the colic episode worse.
• Warm bath/water bottle: Give your baby a warm bath or place a warm water bottle on your baby’s abdominal area. Make sure the water is not too hot by checking it on your hand first and then, for further caution, wrap it in a towel before placing it on the baby. You can also try gently massaging the baby’s stomach and back.
• Try different positions: Some positions are more comfortable for colic babies. For example he might like lying on his stomach in the mother’s lap, or being held with his abdomen resting on the mother’s forearm. As with constipated babies’ cyclic motion, laying a colicky baby on his back and bringing his legs towards his body and pressing his thighs against his abdomen might prove helpful.
• Rhythmic sounds and movements: Colic babies like rhythmic movements and a feeling of closeness. Try rocking or walking your baby or talking him on a car ride.  Rhythmic sounds like those of a dish washer, vacuum cleaner, clothes drier etc. also calm babies down. Some babies also respond well to rhythmic musical tapes.
• Sucking: Allow the baby to suck at the breast, his finger, or a dummy. Sucking in one way or the other sometimes helps babies to calm themselves down.

It is important for parents to allow themselves a break once in a while, as colicky babies can be very taxing on their nerves. Get help and go out for a walk or a movie. Do not feel bad about ‘abandoning’ your baby; you need your time too. It is also important for mothers not to feel guilty about a crying baby. Mothers often tend to feel that way when they can do nothing to pacify their child. Also remember not to feel responsible for the colic, you are not causing it and it is not your fault. Do not let this interfere with the development of a close relationship with the baby. Colic is very common in infants up to 3 months of age, so do not worry, relax and enjoy parenthood

Works and Internet Resources Cited:

• The Complete Pregnancy and Baby Book by Vicki Lansky et al.
• Baby and Child Care by Dr. Benjamin Spock
• The New Parents Guide: http://www.thenewparentsguide.com/babys-and-colic.htm
• T. A. Lawrance at Colic Calm: http://www.coliccalm.com/baby_infant_newborn_articles/baby_colic_treatment.htm
• Medicine Net: http://www.medicinenet.com/colic/article.htm

Every baby is unique when it comes to how many and at what times he has bowel movements. One baby has them at the same time every day; the other always has them at different times. Neither is healthier than the other and there is nothing to be gained by trying to make the irregular one regular in his movements. There is, instead, a chance of upsetting the baby emotionally in the long run.

The function of the large intestine (colon) is to hold undigested and indigestible food and absorb water from it. If, for some reason, the food stays there for longer and an excess of water is absorbed, the stool becomes hard and dry. Conversely, if the food does not stay there for enough time and the appropriate amount of water is not absorbed (as in the case of diarrhea) it can lead to dehydration.

For such a basic function of the human body, there are many misconceptions about bowel habits. Thus, it is important to know what is constipation and what is not.

Is my baby constipated?
Constipation has nothing to do with the number of times a baby has bowel movements, it only has to do with the hardness of the stool. The clearest indication of constipation is when the stool is hard and dry, no matter the number of bowel movements in a day. Other clues you should look for is the number of times your baby has bowel movements. There is no ‘normal’ number for a baby; each baby has his own routine that you will come to know in a few weeks. If your baby is not passing stool as often as he does (especially if he exceeds three days) then he might be constipated. Discomfort at passing stool is a sign of constipation too. However, straining might be normal for a baby, crying means greater discomfort and demands greater attention to the matter.

 
Is there a difference in the tendency of breast-fed and bottle-fed babies to get constipated?
Breast-fed babies rarely get constipated. This is due to the fact that breast milk contains a perfect balance of fats and proteins so the stool it produces is almost always soft. Breast milk is easily digestible and has several helpful types of bacteria that are capable of breaking down some of the otherwise indigestible proteins in milk. Breast milk is a low residue diet and almost all of it is absorbed and used by the baby’s body.

Bottle-fed babies are more likely to become constipated. This could be due to something in the formula composition. Consult your doctor about changing the formula brand. It is important to note however, that the amount of iron in formula milk has no bearing over constipation. Formula milk is also harder to digest so babies receiving only formula milk have lesser bowel movements with a thicker, more greenish kind of stool.

Why is my baby getting constipated?
There could be several causes for constipation: (click for source)

• Formula Milk: As discussed above, if a baby is on formula milk, something in the milk might be causing the constipation. Consult your doctor for suitable changes.
• Diet Imbalances: Constipation is also caused if the diet is imbalanced and does not have enough fiber which passes into the colon and stays there to retain water. This makes the stool softer. A diet without enough fiber does not have the natural softening effect.
• Introduction to Solids: A baby can also get constipated when introduced to solids. This can happen as rice cereal (usually the first solid given) is low in fiber. When a baby is introduced to solids the texture and colour of his stool changes. As the intestines are getting used to this new kind of nutrition the baby might have lesser bowel movements. This does not necessarily mean he is constipated as long as the stool is soft when it appears.
• Dehydration: In warmer climates babies lose more water. Sometimes, due to other reasons, if a baby is not getting enough fluid, it will make his body absorb more water from wherever it can get. This makes the colon absorb excessive water from the food, making the stood hard and dry and difficult to pass.
• A Medical Condition: In a very few cases constipation may be due to some medical condition that the baby suffers from e.g. hypothyroidism, a metabolic disorder, a food allergy or a condition called Hirschsprung’s disease. In some cases constipation can also arise due to some medicines a doctor has subscribed to the baby. In these cases, contact the baby’s doctor for guidance.
• Poor Bowel Habits: Having poor bowel habits means a baby does not have a bowel movement when he feels the urge. As the stool stays in the colon for longer than required, excess water is absorbed leaving it drier and harder. A baby might hold back a bowel movement subconsciously if he has already had a painful experience before. To avoid that pain, he does not want to pass stool. For children being toilet trained, a very strict mother who is very determined to train her child, could be the reason he holds back his stool to assert his independence. Once he does that the stool becomes harder making him more hesitant to make a bowel movement. This can start the vicious cycle of chronic constipation. If a child reacts in this manner it means he is not ready for toilet training yet. It is better to deley it.

How do I treat constipation?

Infant constipation, if it persists, should be brought to a doctor’s notice immediately. There are a few things you can do at home to help the baby with his bowel movements.

• Increasing Fluids: It is helpful to increase the fluids in the baby’s diet. You can do this by making him drink water between the feeding times. You can also introduce fruit juices in his diet e.g. prune, apple and apricot juice. They are rich in sorbitol, a non-digestible sugar that passes through the body to the colon and causes the water to be retained or drawn into the stool mass. Otherwise, chances are that the extra water would only pass out of the body as urine.
• Massaging the Tummy: You can also massage your baby’s tummy in a clockwise manner, starting at the navel and moving outwards. Apply gentle pressure. A little cream or oil on the mother’s fingertips might also help with the massage. Only continue massaging if the baby is comfortable with it.
• Exercising the Baby: It is also helpful to get the baby some exercise. If he has started crawling, let him do a few rounds. If he is not crawling yet, lay him flat on his back and turn his legs in a quick forward cycling motion. Exercising makes the stomach muscles move and puts gentle pressure on the intestines that would in turn, help the easy passage of the stool.
• Giving a Warm Bath: If your baby enjoys bathing, give him a warm bath. It helps him to relax and pass the stool easily. You can also use some cream or vaseline near the outside of the baby’s anus to make it softer.  
• Checking the Formula Milk: If your baby is on formula milk, check if you are preparing it right. Follow the instructions as given on the back of the box. Putting in lesser water and making a thicker mixture can lead to constipation. If the baby’s constipation persists, change his formula milk with the doctor’s consultation. There might be something in that particular brand that is making him constipated.
• Changes in Diet: If your baby is eating a variety of foods you can also boost his fiber in take by adding a spoon of bran to his cereal. You should also cut down on foods that are more prone to causing constipation e.g. rice, bananas, cooked carrots, cheese, yogurt, pasta etc. If your baby is younger and only takes breast milk, increase the number of feeds. If he is bottle fed, give him extra boiled and cooled water.

The Anal Tear:
Sometimes, when the baby passes very hard and dry stool, the anus may get teared. You will be able to see these tears or see blood in his stool. You can apply aloe vera lotion or Vaseline to that area to protect it and help its healing. It is important to alert  your baby’s doctor about these tears and take all steps with his consultation.