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Knowing more about allergy symptoms can help parents recognize a potential problem early on.
Allergies are a damaging immune response that takes place when a person is hypersensitive to an allergen in their environment, whether that is dust, pollen, fur, food, or even formula. Symptoms in babies can range from mild to severe, including not only a stuffy or runny nose and cough, but hives, swelling, redness, a rash or vomiting. In severe cases, symptoms can require immediate medical attention.
That’s why it’s important for parents to monitor the development of any allergy symptoms and discuss prevention and treatment with a healthcare provider.
Allergic conditions tend to run in families. Babies with a sibling or one biological parent who has any kind of allergies are at a higher risk for also developing a food allergy. If both parents have allergies the chance of their baby having food allergies, eczema or asthma is 50 to 80 percent. Babies who have eczema are also likely to have food allergies, so parents may want to have them tested. They may also want to learn the best way to introduce common allergy-promoting foods into the baby’s diet.
Some of the most common allergy-promoting foods are peanuts, tree nuts, cow’s milk, eggs, fish, shellfish such as shrimp or lobster, soy, and wheat. Previously, parents were advised to avoid feeding babies these foods during the first year. However, allergists now recommend introducing them early on as a way to avoid developing allergies.
Most babies begin to eat solid foods at around six months of age. If your child already has eczema or has a sibling with a peanut allergy, your healthcare provider may suggest you introduce allergens such as peanuts and eggs earlier than six months.
The foods should be introduced in small amounts, on a regular basis, with parents noting any reaction. Start by blending a small amount of the common allergen into baby cereal, offer the baby a small bite and wait 10 to 15 minutes before offering it again. If the baby has not developed any allergic symptoms after 15 minutes, parents can offer another small amount of the food and proceed cautiously.
In the past, mothers were advised to avoid common food allergens while pregnant or breastfeeding as a way to prevent the development of allergies in their babies, but there is no research to support this as an effective method. However, breastfeeding your baby until about six months can reduce the risk of developing food allergies.
Formulas can offer a nutritious easily-tolerated alternative when a mother can’t breastfeed or decides not to. However, some babies may be allergic to the ingredients in the most readily available formulas. Signs of an allergy to formula include frequent spitting up, vomiting, abdominal pain, colic-like symptoms, diarrhea, hives, a skin rash or coughing or wheezing. If your baby exhibits any of these symptoms, call your doctor. The solution may be to switch to a hypoallergenic formula.
Environmental allergies can also trigger symptoms:
A baby or toddler can develop symptoms in response to environmental irritants such as dust, pet hair or pollen. Allergies to environmental factors usually produce the easily recognizable symptoms of sneezing, wheezing and coughing, but they may also manifest as hives, a rash on the chest and face or red itchy eyes.
Keeping a home dust or pollen free may be easier than saying goodbye to a beloved pet if that pet is causing an allergic reaction. While one study suggests that being around dogs from birth might reduce the odds of developing some allergies, once a baby has been diagnosed with a pet-related allergy, parents may be advised to keep the pet away from the baby or find the pet a new home.
If a baby or toddler has allergies, parents may be referred to a pediatric allergist, who can test the child and choose an appropriate treatment or combination of treatments. An allergist will first use skin tests to determine exactly what is causing the allergic reactions. Allergy testing done by an allergist is generally safe and effective.
Children do sometimes outgrow specific allergies but more testing may be needed for confirmation.
Unless you’ve been on a desert island, you’ve been hearing a lot about measles lately. There’s a good reason for that: we’ve seen more cases (839 at last count in the U.S.) than any year since 1994. And at this writing we’re only in May. It’s hard to believe that in 2000, the disease was considered eradicated—i.e., gone—in the United States.
We’ll look at how and why this spike is occurring. But let’s first look at why we should be concerned about this increase. After all, many of us, myself included, went through measles and were perfectly fine. Isn’t the disease just another childhood rite of passage?
A Measles Primer
If your “exposure” to measles is primarily from reading Tom Sawyer, you’re not alone in this day and age; many people, including many physicians, have never seen it. That’s one of the problems. The fever, cough, and runny nose that occur during the early stages of the disease can look like a variety of other viruses. There are often white spots in the mouth known as Koplik spots early on, but they’re not always there. Even when they are, they can be missed if we’re not looking for them.
When a rash develops three to five days later, it might provide a clue to measles. But it might not be so obvious that’s what’s going on; many viruses cause rashes that can look similar. And while it is true that a provider’s suspicion for measles is a little higher these days, and while testing is available, in most settings the result doesn’t come back in time to be useful for the patient. (Testing is still important to know what’s going around in the community.)
While Tom recovered to tell a few more tales, others are not so lucky. About 1 in 1000 will get a serious complication such as pneumonia or a brain infection known as encephalitis; both can be fatal. There is also a complication known as subacute sclerosing panencephailitis (SSPE). While much rarer, SSPE strikes several years after infection and causes irreversible brain damage and death. (And as reported on these pages, research has suggested that infants who become infected have a much higher chance of getting SSPE than their counterparts who become infected when older.)
So…Why the Increase?
The Centers for Disease Control and Prevention (CDC) closely track the number of cases, and there’s lots of information regarding the latest numbers on their website. According to the CDC, many of the measles cases have clustered in communities with lower vaccination rates. Generally, for measles, 95% of individuals have to be immune to prevent significant transmission—this is known as the rate needed for herd immunity.
Even with lowered herd immunity, the virus has to be introduced into the community from somewhere. And per the CDC, that somewhere has usually been abroad. The measles vaccination rate is higher in the United States than in many parts of the world. With travel to virtually anywhere becoming increasingly easier, so is the ability of a nonimmune person to bring an unwanted souvenir of the trip—AKA the measles virus—back to America.
Lowering Your Baby’s Risk
Providers really do want to have that dialogue with you about vaccinating your child against measles. They want to get you comfortable with the idea that the risk of complications from a measles infection are so much greater than those from the vaccine. And while no fatalities from measles are listed in the current CDC statistics for the U.S., they are still a force to be reckoned with overseas.
Say you’re on board with the vaccine, but you have an infant. You’re aware that it’s normally not given until your child is 12 months of age. You want to travel, or maybe you’re one of the unlucky ones who lives in an outbreak area. What then?
It turns out that the vaccine (more properly, in this country, the MMR, which protects against measles, mumps and rubella) can be given down to six months of age for infants at risk. While the baby will still need two doses when he’s older, it does offer some protection for potentially exposed babies.
Is your baby under six months of age? You might think about avoiding unnecessary travel, especially abroad or to areas of outbreak in the United States. If you already live in such an area, it’s prudent to keep your baby home; the virus is incredibly contagious, and one infected person in a public building can circulate enough virus to infect others hours later. Finally, by all means, make sure everyone else in the household is vaccinated (if there are seniors in the household, they can be checked for natural immunity).
Nothing is a substitute for a full series of vaccines in offering protection against measles and its complications. The vaccine, however, may offer some protection if given within 72 hours of exposure. And it’s worth having a talk with your provider or infectious disease specialist as soon as possible about other measures that may help lessen the effects of the virus.
Viruses, as well as the risk of contracting them, come and go. Unfortunately, measles doesn’t look like it’s leaving anytime soon. Do what you can to reduce the risk of disease for yourself, your children, and those around you.
Call Your Mother is a podcast run by kveller that features interviews with Jewish mothers. In case you didn’t pick up on it from the title, the guilt is implied. Read more here.
This is important for you because like all stereotypes, that of the overbearing Jewish mother is due to be debunked and this just may be the vehicle to do it.
For women in academic research, when they want to have babies often coincides with the earliest and most vulnerable parts of their career – when they are graduate students, postdocs, or assistant professors. Most universities do not have adequate parental leave plans for them, largely because the US government doesn’t mandate it. Things are looking up at certain universities, but there is still a long way to go. Read more here.
This is important for you because if we want women to continue contributing scientifically, we must give them the tools to do so while they are starting their families.
Podcasting scientists moms
The Story Collider features stories told by scientists; this very special episode highlights two of them as they become mothers. Read more here.
This is important for you because everyone experiences motherhood differently – scientists just analyze it more. We can all learn from, and be entertained by, their stories.
Eat those nuts
Pregnant women because can be scared to eat nuts because of allergies, but new work suggests that eating them – especially during the first trimester – can be good for your baby’s cognition. Nuts contain many nutrients known to be important for fetal brain development, like folic acid and omega-3 and omega-6 fatty acids. Read more here.
This is important for you because nuts are a healthy snack at any time in your life.
The most popular articles on The Pulse this week were Is There an Addiction to Buying Baby Clothes? and Cervical Insufficiency: A Cause of Premature Birth and Rare Maternal Sepsis. Read them here and here.
Waiting to meet your new baby can get uncomfortable. Between body changes and the stress of preparing your life for a newborn, you’re due for some pampering! Massage can be a great way to relax, treat yourself, and even get ready for an easier labor and recovery.
Is Pregnancy Massage Safe?
First, a few disclaimers. While many pregnant people can benefit from a soothing massage, this treatment isn’t for everyone. Before booking an appointment, ask yourself:
Am I out of first trimester? The American Pregnancy Association says massage is okay throughout pregnancy. Some massage therapists or medical providers may disagree. Your first trimester is a particularly sensitive period of prenatal development, with higher risk of miscarriage than in other trimesters. Talk to your doctor about when is a good time for you to begin scheduling massages.
Do I have complications? Massage can reduce or relieve some pregnancy ailments, like back pain or mild edema. People with preeclampsia or risk of preterm labor may be better off avoiding massage.
Is my massage therapist trained in prenatal massage? Your massage therapist should be prepared with special considerations for your positioning, and how to use the right techniques for you.
Types of Pregnancy Massage You’ll Love
Once you’re ready for a rubdown, you’ll find that you’ve got quite a few options. These are some of the best for pregnancy:
Swedish massage: This blend of smooth strokes and muscle squeezing is what many of us envision when we picture a spa massage. Expect to strip down (although you can leave on any clothing you need to feel comfortable), and let your massage therapist know if the pressure is okay. Depending on your session, you may get the massage on your back, butt, and legs, which can help blood circulation and achiness.
Acupressure: Some wellness traditions believe that certain points on the body can be manipulated to promote good health. While acupuncture uses needles, a therapist offering acupressure may use fingers or heated stones to press on certain sensitive points. Acupressure can help you sleep better, and the theory is that the massage will rebalance beneficial energy in your body. This massage is more likely to allow you to remain fully clothed than Swedish massage.
Chiropractor massage: A chiropractor uses various techniques to align your musculoskeletal structure. TV depictions often highlight spinal manipulation, cracking the back or neck. You may not realize massage is often part of the treatment! Chiropractor sessions are often recommended to help turn a breech baby, or promote optimal baby position and pelvic alignment. Expect a firmer, less relaxing approach than Swedish massage or acupressure. One extra bonus of chiropractor massage is your insurance company may be more likely to cover sessions.
At-home massage: In this version, your partner is your massage therapist! Realistically, not all people have the time or disposable cash to schedule the biweekly massages that the American Pregnancy Association says show the most benefits. Ask your partner for a foot and calf rub when you’re relaxing together in the evening. You can also look up videos or ask your doctor, midwife, or doula about massage techniques to try at home. Communicate what feels good and what doesn’t, and you may have a chance to bond and even have some new tricks in your pocket for pain relief during labor.
Once your baby’s born, your world will probably revolve around feedings and diaper changes for quite some time. You may feel physically and emotionally better by taking time to care for your changing body. Massage has shown multiple prenatal health benefits, so it’s certainly worth considering as part of your pregnancy plan.
It’s no secret that breast milk is the ideal food for babies. Your body prepares a perfectly balanced blend of the proteins, sugars, and fats your baby needs, along with tons of great antibodies to boost that little immune system. A lesser-known fact is that breast milk is good for more than filling your baby’s belly. These tricks have been midwives’ secrets for ages, and they’re backed by science, too!
Umbilical Cord Care
In the first days of your baby’s life, they still have a cord stump protruding from their belly button. This stump needs care to avoid infection. Your doctor will most likely advise you to keep the area dry until the cord falls off on its own. This is a widely recommended standard of care, but one study found that breast milk helped umbilical cord stumps fall off faster.
The theory is that breast milk contains enzymes and immune-protecting bodies that encourage the cord to separate and minimize infection. Want to try it yourself? Start by washing your hands well, and then apply a small amount of milk three times per day.
Baby skin is very sensitive. Linger in any new-parent forum, and you’ll see plenty of photos asking about a rash that seems to have popped up out of nowhere. One of the most common is atopic dermatitis, or eczema. This usually looks like a red, itchy, scaly rash.
A 2015 study found that breast milk was comparable to 1% hydrocortisone cream in treating short-term eczema. Since some parents prefer to limit the use of steroid ointments for their babies, and breast milk is cheaper and easier to access (no trip to the store required!), it might make more sense to use breast milk for mild, occasional eczema.
The greasy, flaky, yellowish rash known as cradle cap is also called seborrheic dermatitis. Lots of babies get cradle cap on their head or even their face. It’s often a reaction to residual hormones from your milk, or your baby’s sebaceous glands getting into gear.
There’s some indication that omega-3 fatty acids (like you find in salmon, or walnuts) may help fight this rash. Omega-3 fatty acids can transfer in your breast milk, so tweaking your diet, or taking a fish oil supplement with your pediatrician’s okay, might help. There’s less research about using breast milk topically, but I can attest to it personally. My pediatrician recommended a few drops of topical breast milk to clear up the acne-cradle cap combo on my newborn’s face.
Wash your hands well. Grab a baby wipe and clean your nipple area, too.
Get a small, clean container (a recently washed and disinfected baby bottle works great).
Hand-express milk into the container until you’ve got maybe a tablespoon or two.
Apply milk directly to diaper area and let air-dry completely.
One thing worth noting is that, while breast milk is often a safe and effective treatment for minor baby woes, it’s not necessarily the best treatment for everything. For diaper rash, a thick, zinc-based barrier cream works even better. Severe rashes, or yeast rashes that require an antifungal ointment, may also not be a good fit for the milk treatment.
At your next pediatrician appointment, if there’s a mild issue you’ve noticed, ask the doctor if breast milk is an appropriate treatment. You might be surprised at how far a few drops can go.
When I learned that I had to have a C-Section as my daughter was breech, I will be honest, I was sad, scared and disappointed. I had a vaginal birth with my first daughter and for my second, had set my mind on a water birth. The thought of having surgery terrified me, and whilst I finally adjusted to the change in birth plan and booked my elective section date, my daughter had other ideas, and I went into spontaneous labor a week earlier than planned (in the early hours of the morning)
Whilst the c section procedure went well – a much calmer and relaxed experience than I was expecting, my recovery unfortunately did not. In hindsight I probably did too much too soon, over did it and left myself open to the risk of infection. Hindsight is a wonderful thing.
After 3 days in hospital I was discharged, only to be readmitted in 3 days later, where I stayed until my daughter was 5 weeks old – 34 days post partum. That’s 5 weeks of hospital food, missing my eldest daughter and home comforts, and an incredibly strange start to my daughter’s life.
I was one of the many women who contracted sepsis after childbirth, and I will be honest – I didn’t know much about it at all!
What I now know is that Sepsis is a life threatening infection otherwise known as blood poisoning or septicemia. There are more than 1,000,000 cases of sepsis each year, and according to the Centers for Disease Control and Prevention (CDC), this kind of infection kills more than 258,000 Americans a year.
Recognising the symptoms of Sepsis early is crucial. Left undiagnosed, sepsis can cause the immune system goes into overdrive and reduce blood supply to vital organs, which can lead to multiple organ failure or even death.
In my case I was incredibly lucky – and am very thankful to the doctor who undoubtedly saved my life. I spent three days on an Intravenous drip in a high dependency ward with half hourly observations before I returned to a normal ward. Unfortunately, the sepsis caused some complications and an edema (swelling) on my back which meant I wasn’t able to walk. As the days and weeks went by, I went from wheelchair to zimmer frame, to crutches and then slowly walking unaided. It was very painful and a very long and slow recovery.
Knowing and recognising the signs of Sepsis is so important, as Sepsis can affect anyone at any age but is more common after surgery.
Here are some signs to look out for:
My C-section wound was very red and sore around the edges and boiling hot to the touch. Some pain after a c-section is normal, and as this was my first one I didn’t really know what to expect. It wasn’t oozing or weeping and therefore I didn’t think it was infected but in hindsight the rise in temperature on the site of the wound should have raised some alarm bells.
Fever – my temperature when she checked at the walk in center was over 40 degrees which is incredibly high (normally being around 37). I had experienced some chills and felt shivery and cold at home even though it was summer.
Racing heart / high pulse rate. My resting pulse rate was over 150 – meaning my heart was working very hard!
I felt extremely tired and weak – but again, I had a newborn, and therefore it was easy to blame sleep deprivation and c section recovery.
Finally, and probably the most strange one is that I felt that quite simply, something wasn’t I felt so out of sorts and uncomfortable that I felt the need to go the walk in center and get myself checked as my gut instinct told me something was seriously wrong.
If you have any of these symptoms after a c section please do go and get yourself checked. Whilst you may be busy looking after your new arrival, you need to look after yourself too!
We typically associate the word “addiction” with things like gambling or alcohol, not something as ‘innocent’ as shopping. But the truth is, some shopping habits can become addictive. According to an article by Money.com, shopping can become addictive when it moves beyond an “occasional shopaholic episode” and becomes an obsession that consumes your energy and time and overtakes your life. Shopping is sometimes known as the “smiled-upon addiction,” so it can become easy to slip into addiction since others see it as socially acceptable.
It makes sense that expectant and new mothers (and fathers) get excited about buying cute clothes for their babies. New parents may overspend here or there or occasionally buy too many clothes or toys, but constant overspending may signal the presence of a more serious problem that needs to be addressed.
There are all sorts of posts online from moms who admit they feel like they have a full blown addiction to buying baby clothes. Here are some reasons these moms give for why they are obsessed with shopping:
One common statement in online posts is the designs for baby clothes are cute, especially for girls. It can be difficult to go into stores and see all of the cute baby clothes and not want to buy them.
Many women love the ease of shopping for a baby. Unlike women’s clothes and sizes, you know when you buy baby clothes in the right size, they will more than likely fit your baby and look cute. And because online shopping is so accessible, it easier than ever to buy baby clothes online and get them delivered to your home.
A third reason women described feeling the impulse to buy clothes for their babies was that they get drawn in by sales and finding good deals.
Lastly, some women pointed out that social media is a reason why they love to shop for their babies. The likes and praises for their adorable babies in cute outfits is a motivator to buy more baby clothes and post more photos online.
One possible reason that may explain the development of an addiction may come down to a desire to feel good. Just like an addiction to alcohol or smoking, a shopping addiction can manifest as a way to make a person feel better when other things in their life are not going how they want them to or their life is not fulfilling them. Science has shown some factors may put you at a greater risk for developing a shopping addiction: female gender, anxiety, depression, low self-esteem, and extroversion.
If you feel like you may be addicted to shopping, the following are some questions to ask yourself:
Is shopping causing conflicts in your life? With a significant other or with friends? Issues with credit card companies? Issues with work?
Do you use shopping to change your mood?
Do you feel like you’ve lost control of your buying and spending habits?
To what degree has shopping taken over your life? Is it something that you spend a lot of time thinking about or obsessing over?
Do you feel a lot of pleasure when you make purchases or do you feel withdrawal when a period of time goes between shopping?
Some tips for addressing your shopping addiction include: understanding feelings that make you want to shop; reflecting on the amount of time you spend shopping; keeping a log of your spending habits; and taking control of your finances by budgeting and cutting up your credit cards.
If you are worried that your shopping habits have become a more serious problem or an addiction, it may be helpful to seek the help of counselors or support groups.
In your baby’s first year, she’ll get most of her nutrition from breast milk or formula. Beginning around 6 months, you can introduce new foods to explore. One especially memorable “first food” is the first bite of birthday cake. Have you considered a cake smash as part of your baby’s birthday celebration?
What Is a Cake Smash?
There are few things more adorable than a messy baby enjoying a new treat. Your baby’s likely to get more frosting on her face than in her mouth, so why not make the most of it?
A cake smash lets babies get messy on purpose, digging into a birthday cake with abandon, while a professional photographer captures the moment.
Depending on your area, you may find “cake smash sessions” priced at a few hundred dollars, or close to $1,000 for a full-blown party including setup and cleanup (as well as a bubble bath for baby).
Cake Smash Pros
Who would have thought there were so many benefits to a crumbled cake? Trends take hold for a reason. This is what some families are discovering when they choose a cake smash for baby’s birthday.
It’s fun: At 1 year old, your baby wants to put everything in her mouth. Why not lean into her love of sensory play? The party is a celebration of your baby, so embracing age-appropriate messiness can be more relaxing than aiming for every-hair-in-place perfection.
It’s creative: Many photographers offer various themes, so you can create your own style. You may not have the photography skills to bring your vision of a sugary romp to life, so working with a pro can create a memorable set of photos you’ll cherish when your little one is long past the baby stage.
It’s a crowd-pleaser: It’s the epitome of having your cake and eating it, too. Your loved ones love your baby, and want to watch him enjoy himself. They’d like a slice of celebration cake, too, preferably without a tiny handprint smushing the frosting. A special, mini cake just to smash may be the answer to minimizing wastefulness and maximizing enjoyment for everyone at the party.
Cake Smash Cons
A frosting-fueled photo op isn’t everyone’s, well, slice of cake. Just because everyone in your play group seems to be jumping on the trend doesn’t mean you need to join in, too. Some downsides to a cake smash are:
The cost: Anytime you book a professional photographer, you’re likely adding hundreds to your birthday bill.
The mess: If you stage your own cake smash, you’re stuck with food coloring staining walls, carpet, or baby clothes, all for (hopefully) a few cute pictures.
The sugar: The AAP recommends that parents avoid giving refined sugar to kids under 2 years of age. While that may not be a realistic goal for most families, it might feel like way too much of a good thing to give your baby free rein with a whole cake. What’s wrong with enjoying a single slice?
It’s fine if you prefer to take photos of a clean baby! If you’re looking for a healthier alternative to a cake smash, you’re in luck. There are plenty of creative options available, including yogurt with berries or carving a watermelon “cake.”
As with almost anything in parenting, you’ll find people with varying opinions about whether a cake smash is too cute, a sticky mess, or somewhere in between. Your baby’s first birthday is a time to celebrate the family you’ve become in the last year. If your motto is to embrace the beauty in everyday chaos, a cake smash may be a perfect way to represent this joyful phase of parenting.
The cervix is the lower part of the uterus. Normally, the cervix is firm and closed. During early pregnancy, the cervix provides important physical support for the developing baby and forms a mucus plug that shields the baby from bacteria. Towards the end of pregnancy, after week 37, the cervix becomes softer and gradually dilates, so that it starts to open to the vagina. If the cervix opens too early during gestation, the pregnancy may be at risk. This situation, a condition called cervical insufficiency or incompetent cervix, occurs in about 1% of pregnancies (1). Cervical insufficiency can result in premature birth or miscarriage. In contrast to most first trimester losses, which are due to fetal genetic defects, one out of every four pregnancy losses during the second trimester is believed to be due to an incompetent cervix (2).
Most women who develop cervical insufficiency will not show specific symptoms, but some may experience increased vaginal pressure, bleeding, pain, or discharge. A transvaginal ultrasound can provide a diagnosis if cervical insufficiency is suspected or can be performed to monitor high-risk situations, such as in women with previous second-trimester pregnancy losses. Ultrasound examines the cervical length, dilation, and displacement of fetal membranes into the cervical area as criteria needed to diagnose cervical insufficiency (3). The causes of cervical insufficiency are not completely known, but these may be related to previous structural damage or biochemical changes (3). For example, cervical trauma from difficult past deliveries or a dilation and curettage may lead to long-term cervical weakness. Certain genetic conditions can also weaken the cervix, as can prior in utero exposure to diethylstilbestrol, an estrogenic compound (1, 3). A history of multiple second-trimester losses is considered a reliable risk factor requiring monitoring and proactive prevention of future cervical insufficiency. The main approach for managing cervical insufficiency is cerclage, which is a surgical procedure to stitch the cervix closed. This procedure is believed to prevent almost 90% of cervical insufficiency-associated premature births. In most women who have repeat losses during the second trimester, cerclage is recommended before week 14 to help prevent another premature birth (2, 4).
Although premature birth and miscarriage are well-known concerns associated with cervical insufficiency, maternal sepsis is another, albeit extremely rare complication. Sepsis may happen because the widening cervix permits the mucus plug to escape and no longer serve as a protective barrier to infection. This may allow the genital tract and uterus to be exposed to harmful bacteria. Many cases of maternal sepsis are associated with infection by streptococcus bacteria (5, 6), which can be controlled by systemic antibiotics during early stages. However, an uncontrolled infection could lead to fever with rapid progression to sepsis, resulting in severe organ dysfunction and shock (6). Although sepsis was once a common cause of maternal death, advances in contemporary prenatal care have made maternal sepsis exceedingly rare in developed countries. However, the World Health Organization cites maternal sepsis as an ongoing problem (7), primarily within less developed countries, where routine prenatal care may be lacking. Management of cervical insufficiency is important for preventing the more common consequences of premature delivery and miscarriage, but also for reducing risk of the extremely rare, but life-threatening complication of maternal sepsis.
Of the many things a new baby does, there’s nothing that causes as much stomach distress as her bowel movements. Wait—we’re not talking about the baby’s distress here. It’s the parents who have that uneasy feeling in their stomachs over whether that poop is normal! The variety of stooling patterns, shapes and colors can be, in a word, unsettling.
Many a parent is moved to totally change a little one’s feeding regimen in the hope of producing “the perfect poop.” There’s at least one infant formula out there that’s marketed to those who wish to “normalize” stool production. Perhaps more concerningly, some parents may discontinue breastfeeding or iron-fortified formula with the sole purpose in mind of having a perceived positive effect on the bowels.
If you’re a poop-perturbed parent, let me reassure you. Most infant stooling patterns are normal. Of those that aren’t, most are minor variations that might just need minimal treatment. True infant bowel problems are quite rare; here’s the lowdown.
A First Time for Everything
Among the many things a newborn doctor will look for in a new arrival is a bowel movement within the first day or two. Characteristically, those first stools, known as meconium, are sticky and black. Over the first few days of life, they’ll transition to green or yellow and usually become pasty or seedy. However, what they look like at this stage usually isn’t as important as the fact that the baby is stooling at all; if there’s been no poop by the time the baby is otherwise ready to go home, the doctor will likely consider keeping the baby for tests rather than discharging him. (At this stage, some rare but serious diseases can show up. Newborns with cystic fibrosis often have trouble passing meconium from the beginning. Even rarer is Hirschsprung disease, where the colon doesn’t possess enough nerves for the bowels to effectively move.)
If the baby has passed meconium, but the stool isn’t transitioning, sometimes it’s a sign that the baby isn’t feeding well. Generally, the pediatric provider will look for other signs of poor feeding, such as poor growth and failure to urinate. In other words, where frequency is concerned, the pee is more important than the poop.
A Home Bowel Movement Primer
You may have already heard that breastfed babies tend to have small, yellow-to-mustard stools which can be seedy or pasty. You might also know that formula-fed infants characteristically have greenish-brown, more formed stools. However, there are many variations on the baby poop theme. What this means is that for the most part, if your baby’s stool doesn’t closely resemble that of her comrades of similar age and feeding, it’s probably OK.
What about frequency? Breastfed babies tend to stool more often than their formula-fed counterparts. Curiously, however, many babies taking breast milk regularly skip days. A perfectly happy, healthy baby can, at times, even go a week without a bowel movement! Where breastfeeding is concerned, that’s thought to be due to the fact that breast milk is more completely absorbed, leaving less to be eliminated. It’s worth noting, however, that even babies on formula can also normally skip a day, or even a couple, and be perfectly fine.
True constipation does happen in babies. Suggestions for assessing and treating it are listed here. Providers do differ in their approach to this problem, however, so it’s worth a call to yours if you think your little one might be constipated.
When to Be Concerned
Although as we’ve seen, the majority of stool patterns can be normal, there are a few that can be concerning:
Blood in the stool. This Is almost always a reason to call your baby’s provider. Outside the immediate newborn period, this can mean infection, intolerance to formula, or a problem with the bowels’ structure. Sometimes, a small crack at the rectal opening can cause a few streaks of blood. While this is usually not a serious problem, it’s worth seeking medical attention to rule out other issues.
Black stools. These aren’t universally a problem as sometimes iron in the formula (or, when the time comes, certain solids) can be the cause. However, your pediatrician may want to keep an eye on things; a black color can sometimes also signify bleeding.
White stools. This raises our suspicion for a problem with the liver or nearby structures. Many of these babies will have other problems, such as vomiting, jaundice, or poor growth, but it’s worth bringing this issue up.
Other symptoms. Bowel movement changes might be more of a problem if the baby seems otherwise sick. For example, vomiting in combination with failure to have a bowel movement may mean the bowel is obstructed. A distended (“big”) belly is another sign of trouble.
No parent should have to suffer discomfort over a baby’s bowel movements. If there’s something about the poop that seems concerning, by all means, run it by her provider. Potentially serious issues, which are uncommon, can be addressed. Most of the time, reassurance is all that’s needed—and that will allow you to enjoy everything else she’s doing.