Q: Should a paediatrician be present at every delivery?
A: Ideally, yes! It is very reassuring for the mother and father to see a trusted paediatrician in the delivery room. However, due to time constraints paediatricians are called for deliveries where problems are expected.
Q: When should the neonatal examination take place?
A: Within the first 24 hours the baby should be seen by a paediatrician to make sure that the baby has no congenital abnormalities and that the feeding is getting established. This reassures the parents.
The second examination should take place before the baby is discharged and an appointment is made to see the baby at 10 days to establish that the feeding is going well and that the weight gain is good.
Q: My baby’s head was quite squashed at birth. Will he have a normal shaped head when he grows older or will this squashed head persist? Please advise me as I am very worried.
A: Yes, he has ‘moulding’, which happens when he is squeezed through the birth canal. It will settle soon. However, if he has a cepalohaematoma, (bleeding into the outer surface of the skull) it will take longer to settle as the blood needs to be broken down. Please see your paediatrician.
Q: My newborn baby is having a constant discharge from his left eye? Why is this? What can be done?
A: He probably has a blocked naso-lachrymal duct, which is a little tube that connects the eye to the nose. This is often partially blocked in newborns giving rise to tearing. See your paediatrician who will assess the condition. He will either advise you to massage the inner side of the nose (if it is a mild block) or refer you to an eye surgeon who can open up the canal with a little probe.
Q: My newborn baby is said to have a hydrocoele. Does this require surgery?
A: No, most hydrocoeles get absorbed and do not require surgery. See your paediatrician and discuss the problem with him.
Q: My baby has undescended testes. What needs to be done?
A: Your paediatrician will review your son regularly and monitor the descent of the testes. If it hasn’t descended into the testes by the age of one year, he will need referral to a surgeon who will bring down the testes. The procedure is called orchidoplexy.
Q: My baby boy has a tight foreskin. Will he need circumcision?
A: NO!!! He should be monitored regularly by the paediatrician and you will be advised accordingly. Circumcision is a procedure that is advised only if there are good indications like meatal stenosis, which is a narrowing of the urethra. Also, some parents circumcise their sons for religious reasons.
Dr. Asoka Thenabadu is an experienced paediatrician who has been practicing in the United Kingdom for 33 years. He is undertaking a three month locum in Cayman in the office of Dr. Gordon Smith. Email your questions for Dr. Thenabadu to [email protected]