Ask Dr. Sarah Jarvis

Every mum wants her baby to feed, sleep and fill their nappy. But babies can be sensitive little things, and sometimes, they have problems with feeding and digestion. To help you understand more about common feeding problems, we asked Dr Sarah Jarvis to answer your questions in a live Facebook Q&A. You can read her answers below.

The advice Sarah gave was based on her medical knowledge at the time of publishing (August 2017). If you’re concerned about your baby’s feeding habits or health, speak to your healthcare professional.

Why does my baby get upset when he poos? (He’s not straining and it looks normal!)

Everything to a baby is weird and wonderful, and the world is brand new, even the sensation of pooing which we all take for granted. To do this, your baby has to learn for the first time to contract and relax certain muscles at the same time - no small feat to do for the first few weeks of life. The fact that your baby’s poo looks normal is reassuring, and presumably he’s putting on weight and is otherwise well. But for peace of mind, I suggest seeing your GP or health visitor as soon as you can for some helpful tips and advice. In the meantime, you could try massaging his belly while he poos or putting a warm (not hot) water bottle on his tummy to help him relax. If his crying is high pitched and he is inconsolable, then speak to your doctor or health visitor.

My 6-week-old doesn’t poo every day. Is she constipated?

It can be normal for a baby not to have a dirty nappy every single day. As a general rule, if they’re pooing 2 times or fewer per week and their poo is hard, like pebbles, it can be a sign of constipation, which is something you should pick up with your doctor. Straining to go, smelly wind, poor appetite and lack of energy are other symptoms that can also show up. It’s a fairly common problem for newborns, affecting up to 15% of little ones. The good news is that, if it is constipation, there is plenty you can do such as gently moving your baby’s legs in a bicycling motion and trying some careful tummy massage to help stimulate the bowels.

If you’re formula feeding, you could also look at nutritional solutions, which your doctor will be able to talk you through

My baby gulps air as she feeds – how can I help?

This is very common, so you’re certainly not alone. You and your baby are individuals and so there is no one-position-fits-all, here, and what works for one person may not work for another. It’s worth experimenting with different positions to see what suits you both. There are many good quality videos on YouTube that show different positions or holds for any type of feeding. For example, you could try holding your baby more upright to almost have her sit on your lap in a ‘saddle position’, rather than horizontally.

Once you’ve finished feeding, take extra care to burp her: sitting her on your lap facing away from you, use one arm to support their body and the palm of your hand supporting her chest with your fingers supporting her chin and jaw, lean her forward slightly and gently pat or rub her back for a while with your free hand. It’s also worth making sure the teat of the bottle isn't clogged, and you could speak to your midwife or health visitor about the possibility of changing to a faster-flow teat.

When will my 6-month-old grow out of reflux?

The good news is that for the vast majority of babies, reflux does improve as the valve between the bottom of the gullet and the top of the stomach, which is supposed to stop milk and food refluxing, gets stronger. Most babies have grown out of their symptoms by a year old. Hopefully this is the beginning of that process for your little one.

How can I stop my 16-week-old biting while he’s breastfeeding?

Ouch! I am delighted to hear that you’re breastfeeding but can very much appreciate that a biting baby is not much fun! If he’s teething, let him have a good chew on a cold teething toy to get it out of his system and numb his gums. And if he does bite, draw him close. This makes it a bit more difficult for your baby to breathe through his nose, encouraging him to open his mouth and let go. If your baby is biting because making you yell is a great game, take him away from the breast for a minute.

My baby isn’t keeping milk down – what should I do?

I hope you’ll find it reassuring to know that many babies bring up small amounts of milk after a feed. It might seem like they’ve been bringing up almost all of their feed – but you’d be surprised how much mess even a small amount of milk can make.
I hear from lots of mums that their babies aren’t keeping any milk down, and yet their weight gain shows they’re getting the nutrients they need. If your baby is having plenty of wet nappies (around 6 in 24 hours) and regular dirty nappies, chances are that they’re getting enough food. Clearly, getting him weighed to check he’s putting on the right amount of weight can also give a guide.
Although it can be distressing for parents, generally speaking both reflux and regurgitation are very common and don’t tend to have serious complications. However, please ensure you see a healthcare professional to discuss all your baby’s symptoms. Your health visitor may be a good first port of call. If you have any concerns at all or if you observe any new symptoms such as losing weight, or not putting on weight at the rate he should, you should see your GP as soon as possible.

What’s the difference between reflux and cows’ milk allergy?

Reflux is a condition caused by the valve at the top of the gullet being undeveloped and allowing milk to travel back up the food pipe after feeds, whereas an allergy is an immune system response. Reflux is very common and it can be normal for babies to bring up small amounts of milk after feeds.
However, vomiting and reflux-like symptoms can appear with a cows’ milk allergy, which can also cause tummy pain and diarrhoea, along with red skin, eczema, redness around the bottom, blood in the poos, being off their food and looking pale.
Cows’ milk allergy only affects about 3-5% of babies – so it’s worth bearing in mind that this means in at least 95% of babies this isn’t the cause of symptoms. It's also more likely if a baby has symptoms in more than one part of the body - for instance, skin problems (eczema) as well as tummy problems.
Please do make an appointment with your GP who can investigate the symptoms and offer further advice.

My newborn can’t bring up wind (but is trying), stretches out and screams when she starts feeding and is sleepy. Is this normal?

Please arrange to see your GP or health visitor as soon as you can as they will be able to advise you and give you some helpful tips.
Reflux doesn’t always involve bringing up a lot of milk – pain in her tummy as a result of ‘silent reflux’ can lead to not wanting to feed, arching of the back during or after a feed, or drawing up her legs after a feed. This should definitely be checked out by a doctor quickly.
Don’t forget that it’s normal for a baby to sleep for up to 18 hours a day in the first few weeks after they’re born, and if she’s wide awake some of the time, sleeping a lot is rarely a cause for concern.

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