Baby health scares

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

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.

Falling off the bed

Bam! Your baby isn’t even old enough to roll over — but she pushed herself off the bed while you were looking away.

What to do: Stay calm. Tumbling a foot or two isn’t likely to cause serious injury.

When to get help: Docs differ on this one: Some suggest getting your baby checked over after any fall of more than two or three feet to rule out a skull fracture; others say it’s only necessary if she goes unconscious, vomits or seems “off” afterward. But if you do notice any bumps or swelling, head to the ER.

Croup

You’re awakened by the sound of a seal barking. Your baby’s scary-sounding cough is caused by swelling of the voice box and windpipe, triggered most commonly by a viral infection. Sometimes, the swelling narrows a baby’s already tiny airway, making breathing a chore.

What to do: Bundle your baby up and take him outdoors or into the garage. “Cold air works very well to reduce the swelling,” says Gander. Sometimes sitting in the bathroom with a steamy shower running helps too.

When to get help: If these strategies don’t ease the wracking cough, or the baby’s breathing is laboured (Is she sucking in so hard you can see her ribs? Are her nostrils flaring? Are her lips bluish?), head to the emergency room. There, she’ll be given medication to widen her airway, so you can both go home and get some sleep. “Studies show a small dose of oral steroids reduces multiple visits to ER and days off work for parents,” notes Lim.

Febrile seizures

With no warning, your baby’s body starts twitching and his eyes roll back into his head. Febrile seizures usually strike during a rapid spike in temperature, often before parents even realize the child is sick. And they’re surprisingly common. “About five percent of children will have a febrile seizure, typically between the ages of six months and four or five years,” notes Gander. (A family history of febrile seizures increases a child’s chances of having one.) Usually one-time-only events, febrile seizures are harmless and cause no after-effects.

What to do: Take note of the time the seizure started, and then wait five minutes. If the seizure stops within that time (nearly all do) and your baby seems well otherwise, you can wait until office hours to notify your doctor.

When to get help: If the seizure lasts longer than five minutes, head to hospital or call an ambulance.

High Fever

Your baby feels like he’s burning up. The good news? That means his immune system is working on all cylinders to get rid of a bacterial or viral infection. And a high fever isn’t any more worrisome than a low-grade fever. What’s important is how the child seems otherwise: If he seems like his normal self, chances are he’s fine.

What to do: In itself, fever isn’t dangerous. “The only reason to treat a fever is to make a child more comfortable,” Gander explains. So if your baby is a bit fussy, you can try giving him a weight-appropriate dose of acetaminophen or ibuprofen. (The latter should only be given to kids older than six months.) Sponging isn’t recommended: It can cause shivering, which drives up body temperature.

When to get help: Any fever in a baby under six months should be investigated, since serious infections sometimes don’t cause other symptoms in kids this age. After the six-month mark, contact your doctor if a fever is accompanied by a rash, persistent cough, unusual fussiness or listlessness, or if the temperature lingers for more than 72 hours.

Be prepared!

Take these simple steps now, and you’ll be much more likely to react calmly and think clearly in a crisis:

• Take a first-aid class. To find one in your community, visit sja.ca or redcross.ca/firstaid.
• Learn to take a temperature. Buy a good-quality, easy-to-use thermometer and read the instructions. Also check out the tips at
caringforkids.cps.ca/handouts/fever_and_temperature_taking
• Start a symptom and medication log. Use a notebook to record details, including the date your child got sick, her temperature, the time you gave a medication and the dose.
• Ask for a dosage handout. When you buy acetaminophen or ibuprofen, ask the pharmacist for a chart listing appropriate dosages by weight for that particular product.
• Know your baby’s weight or have a scale handy so you can weigh her.

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