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Baby health scares

A guide to when to worry, what to do and how to get help

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Originally published in Today's Parent October 2011

As if being a new parent weren’t enough to make you anxious, there are several scenarios, commonly occurring during babyhood, that seem specifically designed to provoke parental panic. So if you’re not sure what to do when a fever spikes, croup crops up or your babe falls off the bed, don’t fret. Here’s a guide to what’s harmless and what’s not, what to do when worry is warranted, plus handy hints to help you be prepared.

Blood in diaper/stool

While the sight makes a parent’s blood run cold, a small streak or spot of red in a baby’s diaper is rarely cause for alarm. In breastfed babies, the culprit can be blood from a crack in mom’s nipple, notes Mitzi Pohanka, a public health nurse and certified lactation consultant at the Middlesex-London Health Unit in London, Ont. “Because breastmilk is digested so quickly, the blood goes right through,” she explains.

In newborn girls, suspect number two is a sort of mini-period caused by the withdrawal of mom’s hormones. And a reddish-orange stain in a breastfed baby’s diaper shortly after birth likely isn’t blood at all, but concentrated pee crystals. In older babies, constipation is the most common culprit: Squeezing out hard poop can create tiny tears in the rectum. Possible clues: Straining or distress during a bowel movement or a new food in the diet.

What to do: Pohanka suggests visiting the doctor to check for an anal fissure, but if you suspect constipation is the problem, you can try nursing or offering water more frequently. (Don’t give remedies like diluted prune juice or medication without first checking with the doctor.) And if breastfeeding is painful, or you have cracked nipples, get help correcting your latch.

When to get help: If blood appears in the diaper more than once or twice, or pooping seems painful, check with your doctor, who can help sort out whether there’s an underlying cause like an allergy to cow’s milk. Bloody diarrhea warrants immediate medical attention, since it can signal a serious problem, such as E. coli infection.

Breath holding

Your baby briefly stops breathing, perhaps even turning purple or passing out. “Breath-holding spells are very common,” says Rodrick Lim, an associate professor of paediatrics and medicine at the University of Western Ontario’s Schulich School of Medicine and Dentistry in London, Ont. “About one in 20 kids will have one, usually before the age of five — six to 18 months is the classic age.” Once thought to be temper displays, these episodes result when the body reacts abnormally to excitement, pain or surprise. Breath-holding spells don’t cause any damage and stop on their own as the body’s reflexes kick in. In fact, passing out is a final safeguard: It automatically reboots breathing.

What to do: Hold your baby close to keep him from falling and hurting himself.

When to get help: If your baby has trouble breathing on his own again, or seems unwell afterward, head to the ER or urgent care. A checkup is also a good idea, since some breath holders have anemia.

Choking

Even when parents are vigilant, babies sometimes manage to swallow something that’s just the right size to lodge in a tiny throat.

What to do: “Don’t put your fingers in the baby’s mouth,” which could jam the offending object in deeper, advises Sarah Gander, a Saint John, NB, paediatrician and Canadian Paediatric Society spokesperson. Lay your baby face-down along your arm, tilting him so his head is lower than the rest of his body. Using the heel of your hand, firmly smack the middle of his back five times. If this doesn’t work, you’ll need to administer the infant Heimlich manoeuvre, which you can learn in a first-aid class. And don’t be alarmed if your baby vomits after beginning to breathe again — according to Lim, that’s a normal reaction.

When to get help: If breathing isn’t restored immediately and the baby turns blue, call emergency services. If you remove the blockage, but he continues wheezing or coughing, see a doctor immediately. Even if the baby starts breathing fine, but turned blue during the episode, Gander suggests scheduling a doctor’s visit to evaluate his swallowing ability.

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