11.5: Health

Learning Objectives

1. Describe common physical conditions in infancy.
2. Identify normal patterns of bowel movements and urination in infants and recognize when medical evaluation may be necessary.
3. Explain the symptoms and basic management strategies of frequent infant illnesses.
4. Recognize when a fever or other symptoms in an infant warrant medical attention.

Common Physical Conditions and Issues during Infancy

Some physical conditions and issues are very common during infancy. Many are normal, and the infant's caregivers can deal with them if they occur. Mostly, it is a matter of caregivers learning what is normal for their infant and becoming comfortable with the new routine in the household. New parents and caregivers often have questions about the following:

• Bowel Movements
• Colic
• Diaper Rash
• Spitting Up/Vomiting
• Teething
• Urination
• Jaundice

Bowel Movements

Infants' bowel movements undergo numerous changes in color and consistency, even within the first few days after birth. While the color, consistency, and frequency of stool will vary, hard or dry stools may indicate dehydration, and increased frequency of watery stools may indicate diarrhea.

Figure \(\PageIndex{1}\): An infant getting their diaper changed. Image by Kevin Phillips is licensed under CC BY 2.0.

Colic

Many infants are fussy in the evenings, but if the crying does not stop and gets worse throughout the day or night, it may be caused by colic. According to the American Academy of Pediatrics, approximately one-fifth of all infants develop colic, typically beginning between 2 and 4 weeks of age. They may cry inconsolably or scream, extend or pull up their legs, and pass gas. Their stomachs may be enlarged. The crying spells can occur at any time, although they often worsen in the early evening.

Colic typically improves or resolves by the age of 3 or 4 months. There is no definite explanation for why some infants get colic. Healthcare providers can help ensure that there is no medical reason behind the crying.

Some infants seem to be soothed by being held, rocked, or wrapped snugly in a blanket. Some like a pacifier.

Figure \(\PageIndex{2}\): A father holding a crying infant. Image by David D is licensed under CC BY 2.0.

Teething

Although newborns usually have no visible teeth, baby teeth typically begin to appear around 6 months after birth. During the first few years, all 20 baby teeth will erupt through the gums, and most children will have their full set of these teeth in place by the time they are 3 years old.

An infant's front four teeth usually appear first, at about 6 months of age, although some children don't get their first tooth until 12-14 months. As their teeth break through the gums, some infants become fussy, irritable, lose their appetite, or drool more than usual.

The FDA does not recommend gum-numbing medications with an ingredient called benzocaine because they can cause a potentially fatal condition in young children. Safe forms of relief include a chilled teething ring or gently rubbing the child's gums with a clean finger.

Spitting Up/Vomiting

Spitting up is a common occurrence for young infants and is usually not a sign of a more serious problem. However, if an infant is not gaining weight or exhibits other signs of illness, a healthcare provider should be consulted.

Figure \(\PageIndex{3}\): A father holding his baby with a cloth protecting his shoulder from spit-up. Image by Colin is licensed under CC BY 2.0.

Urination

Infants urinate as often as every 1 to 3 hours or as infrequently as every 4 to 6 hours. In cases of sickness or when the weather is very hot, urine output may drop by half and still be considered normal. If an infant shows any signs of distress while urinating or if any blood is found in a wet diaper, medical care should be sought.

Diaper Rash

A rash on the skin covered by a diaper is quite common. It is usually caused by skin irritation resulting from contact with stool and urine. It can get worse during bouts of diarrhea. Diaper rash usually can be prevented by frequent diaper changes.

Jaundice

Jaundice can cause an infant's skin, eyes, and mouth to turn a yellowish color. The yellow color is caused by a buildup of bilirubin, a substance that is produced in the body during the normal process of breaking down old red blood cells and forming new ones.

Normally, the liver removes bilirubin from the body. However, for many infants, the liver is not yet fully functional in its first few days after birth. As a result, the level of bilirubin in the blood becomes too high, causing the infant's skin to appear slightly yellow—this is known as jaundice. Although jaundice is common and usually not serious, in some cases, high levels of bilirubin could cause brain injury. A healthcare provider should evaluate all infants with jaundice. Many infants need no treatment. Their livers start to catch up quickly and begin to remove bilirubin normally, usually within a few days after birth. For some infants, healthcare providers prescribe phototherapy—a treatment that uses a special lamp—to help break down the bilirubin in their bodies.

Figure \(\PageIndex{4}\): An infant receiving treatment for jaundice. Image by Andres and Antoinette Ricardo used with permission.

Common Illnesses

During infancy and toddlerhood, children are particularly vulnerable to a range of illnesses due to their developing immune systems and exposure to new environments. Some common illnesses during this stage include:

1. Colds and Upper Respiratory Infections - These are caused by viruses, such as the rhinovirus, and are very common in young children. Symptoms include a runny nose, cough, and mild fever.
2. Ear Infections (Otitis Media) - Bacterial or viral infections of the middle ear can cause pain, irritability, and sometimes fever. They are particularly common after upper respiratory infections.
3. Gastroenteritis (Stomach Flu) - Often caused by viruses such as rotavirus or norovirus, and gastroenteritis leads to diarrhea, vomiting, fever, and dehydration.
4. Respiratory Syncytial Virus (RSV)- RSV is a common virus that affects the respiratory system and can cause bronchiolitis or pneumonia, particularly in infants and toddlers.
5. Hand, Foot, and Mouth Disease- Caused by a virus, this illness includes a fever, mouth sores, and a rash on the hands and feet. It is common in children under age 5.

Fever

Most childhood illnesses are self-limiting, but many are accompanied by fever. Parents and caregivers should always consult a physician when a fever reaches 105 degrees Fahrenheit or above, as this can be life-threatening, and the illness causing the fever may require immediate medical attention. However, even a low-grade fever in young children should be closely monitored because it may be a sign of a serious infection. Babies and toddlers, even young children, cannot tell us what they are feeling, so adults should take extra precautions to watch for and correctly interpret symptoms of illness as they occur.

References, Contributors and Attributions

American Academy of Pediatrics. (n.d.). Colic. https://www.healthychildren.org/Engl...ges/Colic.aspx

Centers for Disease Control and Prevention. (n.d.-a). Injury prevention and control: Data and statistics (WISQARS). https://www.cdc.gov/injury/wisqars/index.html

Ricardo, A., & Ricardo, A. (Photographers). (n.d.). Infant receiving jaundice treatment [Photograph].