Nurture Article | The Portland Hospital Parenting Magazine
Spring Issue 2012 | Lucy Elkins
Over a thousand babies are born each day in this country and in their parents’ eyes they are perfect. Yet babies are often born with or develop minor flaws that won’t significantly affect their health but can be a worry for a new parent. So here’s our guide to common baby issues, what causes them and when to seek help.
Birthmarks are extremely common, affecting up to one in 10 children. Doctors are unsure why they develop and, in most cases, there is no medical need for any treatment. There are two main types: hemangiomas or strawberry marks affect 10 per cent of babies and generally appear within the first few months of life. Dr Alex Barnacle, a consultant paediatric interventional radiologist involved in the management of birthmarks at the Portland Hospital, explains: “In 95 per cent of cases, these birthmarks disappear on their own and do not require treatment.
If the birthmark is in a difficult position, for example, near the eye or airway making it difficult for the child to see or breathe, it can be treated with medication or lasers.” The other common form is known as a port wine stain. These are present at birth and more enduring but a variety of different treatment options can reduce the colour or help flatten the mark. Two rarer forms of birthmark are lymphatic malformations or cystic hygromas and venous malformations. These are swellings in or under the skin and can often be treated with injection sclerotherapy or surgery.
Babies are born with soft bone plates which fuse together to form a hard skull during the first two years of life. This makes birth easier but its pliable nature means a baby’s head can become misshapen either through the force of labour or just from the position they like to lie in. “It is common among babies who are good sleepers,” says Mr. Owase Jeelani, a consultant paediatric neurosurgeon at Great Ormond Street Hospital and The Portland Hospital. “Most often they develop a flattened head at the back and a slight bulge at the front. It is purely a cosmetic issue, it will not damage the brain in any way.” Simply getting your baby to spend as much time as possible on their tummy during the day, or changing the position they sleep in so that they are not always lying on the flattened section of their head can help. If that doesn’t work, then talk to your doctor about other options such as special moulded pillows or helmets which help encourage the skull to grow into the correct shape. “The helmets need to be worn for 23 hours a day for a minimum of three months,” says Mr. Jeelani. “That requires dedication but they are effective.” Treatment is most effective in babies aged six to twelve months.
This is a relatively common complaint affecting one in twenty babies to some degree. It is caused by a weakness in the valve at the top of the stomach that normally shuts after a feed to keep food in the stomach. In babies, this valve can be loose and so their feed is able to escape back up the oesophagus causing the child pain. “Babies with this fret more around feeding time and will be especially fussy after a feed or when they lie down,” says Dr Mike Thomson, a consultant paediatric gastroenterologist at The Portland Hospital. “In mild cases, simply giving the baby smaller feeds more often and putting them to sleep with their head raised by 30 degrees can help,” says Dr Thomson. However, in approximately 40 per cent of cases, reflux is linked to a cow’s milk allergy so a doctor may suggest excluding dairy (although only follow this kind of diet with the specific advice of a doctor). Medication such as antacids may also be recommended. Normally, the sphincter at the top of the stomach strengthens naturally by the time the baby reaches between nine and fifteen months of age. “In a tiny minority of cases, surgery will be required to do this,” adds Dr Thomson.
Around two per cent of children are born with noticeably protruding ears and, in a further one per cent, the ears start to stick out around three months of age. Previously, surgery was the only option - but not anymore. “In the first few months of life, the ear cartilage is soft and pliant and you can use a small splint (placed in the hollow part of the external ear) to reshape it,” explains Mr David Gault, a plastic surgeon at The Portland Hospital. “You need to keep them in 24 hours a day for around three weeks and the only real issue is that the ears must be kept dry.” The splints don’t need to be inserted by a doctor and can even be bought over the Internet. (www.earbuddies.co.uk) More severe cases, such as overly large ears can only be modified with surgery. “Unless the need is pressing and, for example, a child needs his ears reshaped to help retain hearing aids, then we don’t operate until a child is five as until this age the ear is not rigid enough for the surgery to be successful,” adds Mr Gault.