Simple Problems, Frequent Questions

Dr. Elías Jiménez

Parents are usually overwhelmed with questions about their child; we will call these frequent worries, simple problems, since most of them are normal situations related to the child's process of maturation. Let's analyze some examples:

1. The mother is breast feeding the child, and she needs to go out. Then she becomes worried because she has to be back on time in order to being able to feed the baby as soon as he wakes up. The reason for the question is that if she is expressing the milk, for how long could she keep it and how? Also she wants to know how much milk does the baby drink?

It is known that maternal milk can remain at room temperature for up to 3 hours; if it is refrigerated it can be kept for 1 or 2 days, and if it is put in the freezer it lasts for a long period of time. Then, if the mother is able to express milk easily, the practical thing would be to do it twice a day, and in this way the milk could be kept in the freezer. This will avoid last minute rushes.

With respect to quantity, a good thumb rule is to determine the child's age in months and add 2 or 3 ounces to it. For example, a baby who is 2 months old will be drinking 4 or 5 oz. of milk. (1 oz = 30 ml)

2. How do bowel movements of breast-fed baby's look? With what frequency have bowel movements?

The appearance and consistency of the movements varies with the baby's feeding and his age. This is why when a baby is a few weeks old and is being breast-fed; his lees are usually yellowish, with white grains and very liquid. An explosive discharge occurs frequently and sometimes this happens every time the baby eats. When the baby is fed with canned milk, discharges are more compact and less frequent. A greenish color, on certain occasions, on the baby's movements should not be of concern.

As the child grows older, movements become less frequent, up to the point that a child who is being breast-fed could have them every four days or more, without this being a problem, especially if these continue to be very soft.

It is a mistake to believe that the child is constipated when he strains to defecate, or when he turns red because of this effort, or if he does not defecate on a daily basis, specially if his movements are soft. This type of situation is normal, and it relates to the child's process of maturation. This process implies the ability to acquire an adequate coordination between the intestinal movement, the rectum distention and the anal sphincter dilatation.

3. Are hiccups and sneezes common on lactating babies? Or does it mean that they are having problems with their digestive or respiratory systems?

Hiccups are common in children, it is related with the swallowing action and with the stomach's distention, and this is due to the fact that the stomach's position in the child facilitates the stimulation of the phrenic nerve. It will disappear spontaneously in a few minutes, it bothers the parents more than it does the child, and its frequency diminishes with the child's growth.

Lactating babies are very sensible to temperature changes, and they will sneeze as a reflex. This situation is perfectly normal and it does not mean that the child has a cold o that he is going to get sick.

4. My child is a month old and he is making a strange noise with his nose. Is he sick?

Children at this age have a smaller and more arched nose at the nasal bridge, so when they breathe the air suffers greater turbulence, especially if the child is lying down. This condition is identified as "physiological nasal murmur". During the night, when temperature decreases, this condition is accentuated. After a few months the noise will disappear. Occasionally, when the child suffers from allergies (i.e. to regular milk) the noise worsens.

5. At what age can the child be seated?

Children can be seated at any age. It is very important that good back and head support is given to the child' during his first months, a good way of obtaining this is by setting the baby's seat at a 45 degree angle. At 3 months of age the baby is able to hold his head up pretty well, so the angle in the carrier can be increased.

6. My child is 6 months old and think he is bowlegged, what can I do?

It is very common for children of this age to have bent legs, as they grow up their legs will straighten up. On the other hand, the belief that children become bow legged when they star walking at a very young age is not true. The child will stand up when he is mature enough to do it and this won't affect him.

All this simple problems are a motive of frequent questions to the pediatrician. All this question reflect the anxiety that parents are going through when they have their first child, this is why we must be patient and understanding in order for this unnecessary worries to disappear and for them be able to enjoy their children.