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Normal Baby Behaviour

· ·

Trusted Resources

Feeding Cues

Babies know when they are hungry and full, so try to tune into the signals they give you. The leaflet below explains some common cues babies use to show they are hungry and ready to feed.

Off to a Good Start leaflet

Pooing

Normal baby pooing is very variable. We would usually expect around two £2 coin-sized dirty nappies in 24 hours in the early days of life, but this will vary depending on the baby. You should see your health visitor or GP if the poos are hard or infrequent (less than 2-3 per week).

Skin to skin

Skin to skin contact can be very helpful to calm both baby and parent – and it’s important for both parents to do this with the baby to help with relationship building, minimising stress, brain development and supporting the baby’s immune system to develop. There is no such thing as too much skin-to-skin!

Crying

Every baby cries, and some babies cry more than others. Babies tend to cry most at about 7 weeks. Reasons for a baby to cry include hunger, a dirty nappy, being tired, wanting a cuddle, wind, or boredom.

Learning to recognise when your baby is hungry will help to reduce their crying. Early signs of hunger include:

  • Rooting
  • Wriggling
  • Sucking fingers
  • Mouth opening.

You can try to soothe your crying baby by:

  • Letting your baby suckle
  • Holding your baby close
  • Using skin-to-skin contact
  • Rocking gently.

Colic is defined as excessive, frequent crying in a baby who appears to be otherwise healthy and well-fed. It affects 1 in 5 babies and stops at around 4-6 months. Looking after a baby with colic can be difficult and tiresome, so it is important to seek support from family and friends.

Crying can be overwhelming, so it is important to know how to cope.

  • Infant crying is normal
  • Comforting methods can help
  • It’s okay to walk away
  • Never, ever shake a baby

For more information and support, visit ICON

Constipation in Children: A Guide for Parents

· ·

What is it?

Constipation is a common issue in children characterised by infrequent bowel movements or difficulty passing poo. It occurs when poo become hard, dry, and difficult to pass, leading to discomfort and straining during bowel movements.

Constipation can be caused by various factors, including diet, dehydration, lack of physical activity, or underlying medical conditions.

What symptoms do you get?

Symptoms of constipation in children may vary but often include infrequent bowel movements, difficulty passing poo, abdominal pain or cramping, bloating, and sometimes small, hard poo that may be painful to pass. Children may be reluctant to use the bathroom due to discomfort or fear of pain.

Sometimes children can develop ‘overflow diarrhoea’ which is loose and smelly. This occurs when there is a large amount of hard poo in the bowel which causes fluid to build up behind it, eventually leaking out and causing diarrhoea.

How is it diagnosed?

Constipation is usually diagnosed based on the child’s symptoms and medical history, along with a physical examination by a healthcare professional. Your healthcare provider may ask about your child’s bowel habits, diet, fluid intake, and any recent changes in behaviour or routine. In some cases, additional tests may be done in order to rule out underlying medical conditions or complications.

It might be useful to keep a diary of your child’s bowel movements. The below linked ERIC website has an excellent poo diary.

What is the treatment?

Treatment for constipation in children typically focuses on relieving symptoms and promoting regular bowel movements. This may include dietary changes such as increasing fibre intake by offering more fruits, vegetables, whole grains, and legumes, as well as encouraging plenty of fluids to prevent dehydration. If your child is a fussy eater, have a look here for helpful tips. Regular physical activity can also help stimulate bowel movements and promote digestive health. In many cases, your healthcare provider may recommend laxatives or poo softeners to help soften poo and ease passage. Additionally, establishing a regular bathroom routine and encouraging your child to use the bathroom when they feel the urge can help prevent constipation from recurring.

Remember, while occasional constipation is common and usually resolves with simple lifestyle changes, persistent or severe constipation may require further evaluation and management by a healthcare professional.

Feeding Difficulties in Babies

· ·

Trusted Resources

Community Breastfeeding Support

We wish to support all families in Lothian with infant feeding and building a close and loving relationship with their newborn.

The best way to begin is to spend as much time as possible in skin-to-skin contact with your baby in their early days and weeks – have a babymoon.

If you need infant feeding support, speak to your midwife, health visitor or family nurse.

Community-based support is also available for all families. Visit “Breastfeeding in the Lothians Linktree“.

You will find helpful information online by searching for:

  • Parent Club – Feeding
  • NHS Lothian – Feeding Your Baby

If you need a paper copy of the group details, ask your midwife, health visitor or family nurse.

Download Community Breastfeeding Support Leaflet 

Breastfeeding

Breastfeeding is extremely powerful in establishing a strong mother-baby bond and provides your baby with the nutrients and energy they need to live and grow. Each baby feeds differently, and there is no such thing as “normal” breastfeeding.

Characteristics that indicate healthy, successful breastfeeding in a baby over 7 days old include:

  • 5-40 minutes for each feed
  • At least 8 feeds or more per 24 hours
  • Feeding from both breasts at every feed
  • Deep rhythmic sucks and swallowing
  • Comes off the breast on their own
  • Around 6 heavy wet nappies per day
  • Passing stool regularly (at least two £2 coin-sized stools per day when under 6 weeks old)
  • Gaining weight

UNICEF have excellent online resources for establishing successful breastfeeding called “Baby Friendly Resources“.

If you are concerned about your baby’s breastfeeding, ask your health visitor or midwife for advice. Seek advice in particular if your baby:

  • Always falls asleep on the breast/never finishes the feed
  • Comes on and off the breast frequently.

Crying

Every baby cries, and some babies cry more than others. Babies tend to cry most at about 7 weeks. Reasons for a baby to cry include hunger, a dirty nappy, being tired, wanting a cuddle, wind, or boredom.

Learning to recognise when your baby is hungry will help to reduce their crying. Early signs of hunger include:

  • Rooting
  • Wriggling
  • Sucking fingers
  • Mouth opening.

You can try to soothe your crying baby by:

  • Letting your baby suckle
  • Holding your baby close
  • Using skin-to-skin contact
  • Rocking gently.

Colic is defined as excessive, frequent crying in a baby who appears to be otherwise healthy and well-fed. It affects 1 in 5 babies and stops at around 4-6 months. Looking after a baby with colic can be difficult and tiresome, so it is important to seek support from family and friends.

Vomiting

It can be normal for babies to vomit. Babies can vomit for many reasons, including reflux, overfeeding, allergy or infection (either in the gut or elsewhere). If your baby starts to vomit, keep a close eye on them and try to feed your baby little and often.

If you are concerned about your baby’s vomiting, ask your health visitor, pharmacist or GP for advice. Seek urgent advice in particular if your baby:

  • Has sick that’s green or has blood in it
  • Has blood in their poo
  • Has a swollen or tender tummy
  • Has a high temperature
  • Keeps being sick and can’t keep fluid down
  • Has signs of dehydration
  • Will not stop crying and is very distressed
  • Is refusing to feed
  • Stops having wet nappies.

Reflux

Many babies bring up some milk after feeding – this is called posseting. It is sometimes also called baby reflux and is usually nothing to worry about. It happens because muscles at the base of your baby’s food pipe have not fully developed, so milk can come back up easily. It occurs during the first year of life and improves with age.

You can help reduce posseting by burping your baby frequently, holding your baby upright during and after feeding, and reducing active play after feeding. NHS.co.uk have a useful article called “Reflux in babies“.

If you are concerned about your baby’s vomiting or if your baby is distressed, ask your health visitor or pharmacist for advice. They may suggest treatments such as a thickening powder or medicines. Make an appointment with your GP if your baby:

  • Is not improving after 2 weeks of trying things to ease reflux
  • Starts having reflux for the first time after they’re 6 months old
  • Is older than 1 year and still has reflux
  • Is not gaining weight or is losing weight.

Cow’s milk protein allergy

Cow’s milk protein allergy (CMPA) is rare in babies (approximately 2%). It is caused by the baby’s immune system reacting to the proteins in cow’s milk. There are 2 types of CMPA: immediate reaction and delayed reaction.

In an immediate reaction, the baby will develop symptoms usually within an hour after ingesting dairy. Symptoms include an itchy rash, swelling of the mouth/lips and vomiting.

In a delayed response, symptoms occur up to 72 hours after ingesting dairy. There are often several symptoms, including vomiting, abdominal pain, constipation/diarrhoea, bloody stool, poor growth, and rashes. If you are concerned about CMPA, ask your health visitor, pharmacist or GP for advice.

There is no medical test that can accurately diagnose CMPA. If your doctor thinks your baby might have CMPA, they may suggest that you eliminate dairy products from your baby’s diet.

If your baby has CMPA, it can take up to 4 weeks for dairy avoidance to improve symptoms. Soya milk should not be used as a dairy alternative in babies under 6 months old. Do not change your diet if you are breastfeeding without medical advice.

Baby-friendly accredited

A group of healthcare staff stand around a man in a suit who is seated at an outdoor table signing a document. The group is smiling and posing together outside a hospital building on a sunny day.

The Royal Hospital for Children and Young People in Edinburgh were proud to receive Baby Friendly accreditation from UNICEF.

Eating well

· ·

Many children go through phases of refusing to eat certain foods or even at times refusing to eat anything at all. This is common in young children when they are trying to show their independence. Although it may be worrying, it will not be harmful if your child doesn’t eat for a short period.

Golden Rules aka Division of Responsibility

As a parent you should decide on:

    • What, when & where foods are offered.

It is up to your child to decide:

    • If they want to eat, how much they want to eat, and in which order.

Environment

  • Remove all distractions, e.g. TV, radio, toys, pets.
  • Eat together as a family.
  • Sit down at the table to eat.
  • Seat your child so they are well supported & within easy reach of their plate/cups/utensils.
  • Create a happy, relaxed atmosphere.

Choice

  • Offer the same foods as the family eats – don’t prepare separate “special” meals.
  • Continue to offer foods (on separate occasions) that have been previously refused. It may take a few exposures for a child to accept new foods.
  • Don’t assume a child will dislike a particular food.
  • Offer a new food alongside a familiar (liked) food.
  • If they refuse food, do not offer.

Meal-times

  • Offer very small amounts – too much food may overwhelm your child. Praise them when this is eaten and gradually increase the amounts offered.
  • Encourage self-feeding, even if they are messy – table manners can develop later!
  • Expect, allow & prepare for mess – place splash mats & newspaper on the floor. Clean up calmly at the end.
  • Wipe sticky hands & face after the meal.

Timing

  • Offer 3 meals. Some children may need snacks in-between.
  • Set meals are better than “grazing”.
  • Limit meal times to 20 – 30 minutes.
  • Praise your child when they eat.
  • Don’t become anxious, “fuss” or argue with your child.
  • Learn to read cues—stop if they are turning their head away or clamping their mouth.
  • Don’t rush your child to finish eating.
  • Don’t force them; calmly remove the food after 30 minutes.

Viral Gastroenteritis: A Guide for Parents

· ·

What is it?

Viral gastroenteritis, often referred to as a stomach bug, is an infection of the intestines caused by various viruses, such as norovirus, rotavirus, or adenovirus. It is highly contagious and can spread easily. Viral gastroenteritis is a common illness, particularly in children.

What symptoms do you get?

The symptoms of viral gastroenteritis usually include sudden onset of diarrhoea, which may be watery or contain mucus, as well as vomiting, stomach cramps, nausea, and sometimes fever. The usual duration of diarrhoea is 5-7 days and in most children it stops within 2 weeks. The usual duration of vomiting is 1-2 days and in most children it stops within 3 days.

How is it diagnosed?

Viral gastroenteritis is typically diagnosed based on the child’s symptoms and a physical examination by a healthcare professional. In most cases, specific tests to identify the virus causing the infection are not necessary, as the illness is usually self-limiting and resolves on its own without specific treatment. However, in severe cases or if complications are suspected, your healthcare provider may recommend stool tests or other diagnostic tests to rule out other possible causes of the symptoms.

What is the treatment?

Treatment for viral gastroenteritis focuses on relieving symptoms and preventing dehydration. ‘It’s essential to keep your child well-hydrated by offering frequent sips of sugary fluids, avoiding fizzy drinks. You can also consider oral rehydration solutions, such as dioralyte, which is available in supermarkets and chemists. You can also offer bland, easy-to-digest foods such as crackers, rice, bananas, and toast as tolerated. In some cases, your healthcare provider may recommend anti-nausea medications, but these are typically reserved for more severe cases or for children at higher risk of dehydration. To help prevent the spread, wash your hands with soap and water regularly, especially after going to the toilet, changing a nappy or before touching food. Your child should stay off nursery/school until 48 hours after vomiting and diarrhoea.

Remember, viral gastroenteritis is usually a self-limiting illness that resolves on its own within a few days to a week with proper care and hydration. However, it’s important to monitor your child closely for signs of dehydration, such as decreased urine output, dry mouth, or lethargy, and seek medical advice if you have any concerns.

Use this quick guide to know what signs to look out for in your child.

Contact NHS Lothian