By Leah Smith, MD, FAAP, Lexington Pediatric Practice Gilbert
As a pediatrician in practice more than 20 years, I have talked with hundreds of new parents about their fears and worries. Let's be honest. You’ve just been sent home with a precious tiny baby, and newborns do some weird stuff. Most of the time, your pediatrician will nod and tell you it's normal and not to worry. Here are a few of the most common weird (and wonderful) things your newborn may experience.
1. Hiccups
Newborns will have hiccups after almost every feeding. This has nothing to do with how or what you fed them. It isn't caused by what the mother ate or by not burping properly, so don’t blame yourself.
Instead, hiccups are a normal reflex, and in babies, even the smallest stimuli can set them off. For example, a full stomach can push on the diaphragm and cause it to spasm. Even though they look dramatic because their ribs are so soft and pliable, they are not painful or harmful.
Hiccups should only cause concern if they are prolonged or interfere with feeding, which is very rare.
2. Eyes crossing
You may notice that your baby's eyes are not perfectly coordinated. They go in opposite directions, cross, and can look "lazy." I often hear from parents that they are worried this means their baby will have a permanent vision problem, but intermittent misalignment is common early on and improves during the first few months.
If you continue to see irregular eye movements after four months, bring it to your pediatrician's attention. We can do additional examination and testing in our office, and can refer you to a pediatric ophthalmologist if needed.
3. Stuffy nose
Babies are small and so are their nasal passages. This can cause their breathing to sound surprisingly noisy, often making it seem like their nose is clogged or congested.
It is reasonable to try to clear the nose with saline and bulb suction, but if nothing changes and the baby is feeding well, there is no reason to worry. If a baby's nose is fully blocked, then they will not be able to stay latched onto the breast or bottle, and you should have them evaluated. Severe blockage is usually detected in the newborn nursery before you ever take the baby home.
Also, if their cry always sounds hoarse or the noisy breathing is constant, then their doctor should evaluate them for other airway abnormalities.
4. Spitting up
Almost all babies spit up. Their stomach is only inches from their mouth, and the sphincter muscle at the top of the stomach has not fully matured yet. So, any movement or bearing down to poop can cause the milk to overflow, like a pop-off valve.
Usually this is just a small amount of milk, sometimes curdled and chunky, that softly flows into or out of the mouth. Sometimes the spitting up can be more dramatic, including a larger volume or even coming through the nose. Your baby may briefly hold their breath because they're startled, too. If this happens, gently clear the nostrils with a bulb syringe or pat them on the back, and they should quickly return to normal.
We become concerned about spitting up for a few reasons. First, if the baby is fussy with spitting up, that can be a sign of heartburn or gastroesophageal reflux disorder (GERD), and you should discuss management of this condition with your pediatrician.
More importantly, significant reflux can keep babies from gaining weight appropriately. If your baby is spitting up frequently or the volume is increasing, see your pediatrician so they can compare their weight to the last visit.
Most importantly, if what you thought was spitting up becomes forceful or projectile (think vomiting that shoots out several feet from the mouth), is bright neon green, or contains blood, seek prompt medical attention. These can signal a blockage or another condition that needs further evaluation. Seek urgent care if there is any trouble breathing, change in the baby’s color, or if the baby appears dehydrated or unusually ill.
5. Bowed legs
Babies are wrapped up tight in the womb, and this can leave much of their body a little misshapen in the beginning. One place we see this is in the legs. Babies spend nine months in the "fetal position," and this leaves their hips rotated outward and their shins rotated inward, which makes their legs look bowed.
The solution? Time–and a little gravity. As babies grow, crawl, stand, and walk, their legs should gradually become straighter. This can take time, and normal alignment changes can continue through early childhood.
If you are concerned that your child's legs are more severely bowed or the bowing is not improving as your child grows, discuss it with your doctor. They can do an additional examination and, if needed, testing for other causes such as nutritional deficiencies.
This information is for general education and does not replace an examination by your child's healthcare professional.
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