Troubleshooting baby problems can be a major challenge for new parents, especially since infants are unable to communicate their discomfort and needs. In the first of a two-part article, Dr Alvin Ngeow, Consultant, Department of Neonatal and Developmental Medicine, Singapore General Hospital (SGH), highlights five of 10 common problems, and offers simple solutions for concerned parents. The second part will be published in the next issue.

1 Jaundice

About 60 per cent of full-term babies and 85 per cent of preterm babies suffer from jaundice. Most cases are physiological jaundice, which is generally harmless and relates to the immaturity of the baby’s liver.

Doctor’s advice: Prolonged jaundice may have lifelong implications. If a four- to six-week-old baby continues to suffer from jaundice, further medical checks and blood tests may be recommended.

Red flags: Pathological jaundice tends to start on the first day of life and advance quickly. It can be due to infection, inherited genetic problems, or the mother and baby belonging to incompatible blood groups. Extremely high jaundice levels may cause brain damage.

2 Vomiting

This is usually due to gastroesophageal reflux since the muscle tone between the food pipe and the stomach is not very well established. It takes one hour for the baby’s stomach to empty milk into the intestines, so if parents put him back into the cot immediately after a feed, lying down may cause him to regurgitate.

Doctor’s advice: Hold your baby with his head in an elevated position for 15 to 20 minutes after a feed to give him time to partially empty the stomach.

Red flags: Gastroesophageal reflux disease is less common, and refers to more severe cases, where the stomach acid burns the food pipe and causes heartburn. The infant may arch his back or even refuse to feed. Vomiting may also be due to urinary tract infection, a blockage in the stomach, or head injury or infection.

3 Colic

For babies less than four to five months old, colic generally refers to more than three hours of crying a day, for more than three days a week, and for more than one week. Although it has no known cause, it is usually harmless and resolves at around three months of age.

Doctor’s advice: Check if the baby is hungry, tired, or needs a diaper change before considering if it is colic. In cases of severe colic, try introducing a probiotic for breastfed babies, or switching to more easily digestible partially hydrolysed milk formulas. Colic and crying can push parents into postpartum depression, so stressed parents should try to take time off and get help from someone they trust.

Red flags: Persistent crying along with symptoms, such as fever, a drop in body temperature, and extreme changes in babies’ activity level, may suggest other illnesses. It is best to seek prompt medical advice.

4 Abdomen distension

This is due to infants’ lax abdomen muscle wall, which has to hold in many internal organs and some pelvic organs. Mild distension can also be due to a recent milk feed or because the baby swallowed a lot of air while crying.

Doctor’s advice: This is normal so parents need not worry.

Red flags: Seek medical advice if the abdomen is very distended, and other symptoms, such as vomiting or the lack of bowel movement, are present. This can be caused by air, fluid, faeces, enlarged organs, or in rare cases, tumours.

5 Plagiocephaly (flat head syndrome)

The back of a baby’s head can appear flat due to repeated pressure from the bed when it is lying down. In many cases where one side of the cot is facing the wall, one side of the infant’s head may be flatter than the other, as the baby is prompted to turn outwards rather than staring at the wall.

Doctor’s advice: Reduce pressure on the back of the head by alternating the head position. Try positioning the baby’s head alternately on the two ends of the cot so that when he looks outwards, he will either be looking to the right or to the left. Parents may also consider helmet therapy or approach a physiotherapist for stretching exercises for the baby’s neck.

Red flags: Doctors will check to eliminate the possibility of craniosynostosis, the premature fusion of the cranial sutures.