The skin tells us a lot about a baby's health

A few moms have asked me to write something about birthmarks and skin rashes, so here are some examples and practical tips. I hope this helps.

Birthmarks are simply patches of discoloured skin usually caused by extra blood supply. Birthmarks can be flat or raised, be there at birth or appear later. While some are temporary and fade, others become more prominent and permanent as your baby grows older.

Examples of temporary birthmarks:

• ‘Stork bites’ are usually found on baby’s neck, forehead, eyelids or nose and are most noticeable when baby cries. They’ve usually faded by the age of 2.

• Strawberry naevus is a small but fiercely red raised patch that looks like a strawberry. Luckily these disappear after a few years, but often look worse before fading, and can bleed. Light pressure with a clean piece of gauze will stop the bleeding.

• Mongolian spots look like a bruise and is often on the lower back or bottom. If not warned, mothers may worry that she will be accused of smacking her baby! These don’t hurt and will disappear by the time the child goes to school.

Permanent birthmarks:

• Brown birthmarks (called moles) are circular and sometimes hairy. These should be seen by a dermatologist.

• Port wine stain describes this red patch of skin that can unfortunately be on the face, forehead, arms and legs. The redness may fade, but it’s best to get advice from a dermatologist.

What can you do?

Speak to your clinic sister or house doctor but don’t use old-wives’ remedies. Disfiguring permanent birthmarks can be treated with a variety of techniques or cosmetic surgery today. Don’t make a big thing of the birthmark so that your child feels self-conscious. As a child I developed a small black mole on my leg. My mother called it a ‘sputnik’ because it appeared when the first sputnik was launched. Imagine my surprise when I learned what a sputnik is – and my disappointment that mine was just a small mole after all!

Rashes

Your baby’s skin is protected by vernix – a creamy, water-proof moisturising barrier cream – during the pregnancy. To date, the cosmetic industry has not been able to match this magic cream, and midwives, aware of its nutritional and protective value, don’t wash the vernix off immediately after the birth the way we used to. The baby is simply wiped clean for the first 24 hours so that the vernix can be absorbed.

• Peeling skin. Babies who have gone beyond their expected due date may have drier

skin that flakes. Bathing with fragrance-free aqueous cream helps.

• Milia are small white spots that are said to be caused by blocked oil glands. These are

not pimples – so don’t squeeze them! Clean baby’s face with cotton wool and cooled,

boiled water. The spots will clear on their own.

• Baby acne. This is very common after the first few weeks, and like adolescent acne, is

caused by hormonal changes. These are withdrawal hormones baby received from you

during the pregnancy.

• Nappy rash occurs in the nappy area and may be caused from the ammonia in the

urine, nappy irritation or soft stools. Clean the skin well after every nappy change – even

when the nappy is only wet – and leave the nappy off for a while for the skin to dry

properly. Short snaps of sunshine also helps. Use a zinc and castor-oil based barrier

cream.

• Cradle cap occurs on baby head, and may reach over the forehead onto the

eyebrows. This is caused by overactive oil glands and can look thick and discoloured.

Leave baby oil on these patches overnight, and they’ll be easy to wash off with a soft

sponge the next day. Repeat daily if necessary.

• Eczema is common in older babies – often when they’re weaned off breast milk. Skin

becomes dry and sensitive. Eczema can also be sparked by an allergy. It usually occurs

on the face and in folds like elbows and the back of knees. It’s best to see a doctor who

will prescribe a mild cortisone cream. Use this sparingly and follow instructions. Make

sure baby’s clothes are well rinsed of soaps and detergents and only use baby skin

care products.

Common childhood rashes are usually symptoms of childhood illnesses such as measles, German measles, roseola, chicken pox or scarlet fever. These should be diagnosed by a doctor because many of these are also notifiable diseases. Symptoms are treated and the child is kept comfortable and away from other children while infectious.

Less often, rashes can be caused by allergies e.g. egg white, or parasites e.g. scabies.

The skin is classified as a body organ because it’s essential for our survival. Because it covers such a big area, the skin is considered to be the biggest body organ. It’s really important to look after our skin – especially baby’s skin. Early childhood lays down the foundations of healthy skin. Your children will thank you when they’re older.

Food, glorious food ….

You don’t need to introduce solids until your baby is at least six months. Breast milk is always best, and if possible, continued till baby’s first birthday. Young babies don’t need water, juice, or tea between feeds. 

Babies learn to eat what the family eats. When plates are loaded with empty calories and fried fast foods, children grow up looking like their parents. Early parenthood comes with learning to ditch bad habits. 

• By six months, babies are able to control their heads, sit and chew so they won’t choke. 

• Their maturing immune system means that you don’t have to sterilise eating utensils. Just make sure they’re clean

• Their little stomachs can stretch and digest soft solids

• Intestines are making enzymes to break down solids and absorb nutrients

• Allergies are less likely after six months

• Older babies need protein for brain development

• They enjoy experimenting with new tastes and textures.

First soft solids can be fruit (mashed banana or paw-paw) instant rice cereal or cooked porridge. After a few weeks, lunch can be a cooked, pureed/mashed vegetable e.g. squash, butternut or pumpkin (add a bit of milk to soften – but not salt, butter or sugar). Other soft vegetables like baby marrow or mashed potato can be added after another few weeks. When baby is tolerating a vegetarian diet, introduce proteins – soft chicken breast, fine mince or flaked fish. 

Don’t rush introducing new tastes, flavours and textures. Let it take six months so that by baby’s first Birthday, food can come from the family pot.  

Pre-toddlers (age 1 – 2) still need milk – breast milk or formula can be weaned to full cream cow’s milk. Water, fresh fruit juice or unsweetened tea is preferable to sugar-loaded soda’s. Your baby’s growth will slow down; he will need less sleep during the day and healthy finger and snack food can be introduced. Don’t use food to bribe. Remember that pre-toddlers have an instinct to kill their food so don’t be disheartened when he demolishes what looked like an appetising meal into mush before eating it! He is still using all his senses – touch, taste, smell, sight and sound when learning about food and eating. Put newspaper on the floor.

Finger-foods also help tots to practice their fine motor skills – grasping, using their thumbs and transferring. Try frozen vegetable mixes like peas and carrots, fresh banana or toast fingers. Avoid pop-corn, peanuts, raisons, grapes and hard-boiled sweets – they’re a choking hazard. 

By the time your toddler is three, his energy needs will have zoomed to 5 500 kj./day. Toddlers need more carbohydrates, natural sugars (i.e. fruits) and dairy e.g. full cream milk, yogurt and cheese. Complex carbohydrates (cereals, bread, pasta, rice, potatoes etc.) are digested slowly which means that the energy they produce lasts longer. 

Just follow these simple steps and introducing solids will be a breeze!