Ask Dr Yiannis

Our new series of chats with Dr Yiannis Ioannou, Consultant Paediatrician at the Portland Hospital who can answer baby health questions

Dr Yiannis sees babies and children of all ages in his clinic every day for health checks and vaccinations. He treats all conditions affecting children from birth to their teenage years, including infant feeding difficulties, reflux and colic, constipation, abdominal pain, coughing, wheezing, skin rashes and infections.

We asked Dr Yiannis about some of the most common concerns for new parents and how he reassures first- time Mummies and Daddies.

B asks: Many new Mummies are concerned that they are not producing enough milk for their baby. How do you reassure them that their milk is all their baby needs?

Dr Yiannis: Firstly, new parents should be reassured that their baby will lose some of his birthweight during the first couple of weeks and that this is completely normal. Babies can lose up to 10 per cent of their birth weight and that much is acceptable; perhaps even a little more is absolutely fine. This is a measure that allows midwives to know whether your baby is doing well. If it seems that your little one is losing more than that, then they need to be checked.

breastfeeding

Should a baby lose more, he may be dehydrated, which may be a sign of
a problem somewhere else; a reddish tinge in the nappy might indicate urate crystals, a sign of dehydration. Too much weight loss can also make jaundice worse – one of the treatments for jaundice is to ensure that your baby is getting enough fluids.

Generally, if a baby seems comfortable, is having frequent wet nappies and is passing stools regularly, has no other signs of a problem like fever, then these are signs that your baby is doing well and is making good progress.

Read Dr Yiannis’ guide to winter bugs

B asks: Does a baby’s weight change much during the early weeks?

Dr Yiannis: I often see babies who are referred to me because there has been a change in where the baby sits on the weight percentile (the chart in your baby’s development book – see box below) during the first few months. Again, it’s completely normal for babies to adjust between percentiles, so a baby might be born on the 50th percentile and then adjust up or down during the first months – and that’s normal.

B asks: If a baby is not gaining weight and is referred to you, what do you look for?

Dr Yiannis: I would ask how the baby is feeding and how often. For first time mums, especially when their baby is exclusively breastfed, it can take a week or two for the milk supply to establish. This is one of the reasons why regular contact with your midwife and doctor is so important to reassure you that your baby is thriving. I would look to see if the baby seems generally well; for example, does he have a temperature that might indicate an infection? I would then do a ‘top to toe’ examination that checks everything, making sure to look in the baby’s mouth, checking that the palate is fine, listening to the heart and so on.

Read all about your baby’s immunisations

B asks: What’s the best way to establish a good supply of milk?

Dr Yiannis: Putting your baby to the breast is the best way to promote breastfeeding, because of the hormonal interactions that happen between mum and baby. Mum should get some help and have lots of rest and regular hydration too.

B asks: If a baby was born prematurely or had a low birth weight, should parents consider having regular appointments with a Paediatrician to ensure that potential health problems are avoided?

Dr Yiannis: A baby that is born at term and is healthy will have regular checks with their health professionals. If a baby is born with specific issues, they will need to be checked by a doctor and they may also need additional checks such as blood tests.
The purpose of all checks is the early identification of any concerns, where health professionals can make early interventions. These also help to allay anxieties and concerns for parents.

It’s important to remember that much of your baby’s development happens in the early years, so it’s good to make interventions early if they are needed.

If a baby is born very prematurely, there is a very well-established follow up pathway through the hospital; the baby will have regular checks to assess for issues related to feeding, reflux, developmental concerns and hearing or visual problems. The usual health checks should apply, such as having routine vaccinations, and taking vitamins too.

B asks: Many Mummies have heard that giving their baby ‘tummy time’ is good for them – but why is that and what’s the best way to do it?

Dr Yiannis: I encourage tummy time; think of it as a workout for your baby! Physically, it helps build strength in the back and neck muscles and leads to the improvement of motor development. It’s all about core muscle strength, leading to the ability to control the head and then to sit up, push up from lying on the floor, roll over and so on. Newborns won’t tolerate tummy time for long; make sure that your baby is awake and alert and use this as part of playtime with your baby.

Safe sleep advice is always for your baby to sleep flat on their back but babies spend so much time in this position, it may lead to Placiocephaly or flat head syndrome.

One of the neck muscles may be tighter on one side, so the baby spends more time with their head turned in one direction. Awake tummy time is therefore an excellent way of keeping pressure off the skull and can help with keeping a symmetrical head shape.

Read about breastfeeding your baby in the early days and more about your baby’s health and development in our helpful features on the website

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