Useful information for parents with babies and your children

Dr Reynolds, private paediatrician in surrey and berkshire

Dr. Reynolds answers some common questions asked by parents

Probiotics - what are they and should my baby/child take them?

"Many parents have been asking me about the use of probiotics in babies. Probiotics are the live, "good" bacteria which normally live in the gut, and Bifidobacteria are the main species in babies and infants, along with Lactobacilli as another important normal flora in the gut. If a mother has received antibiotics at the time of delivery, or whilst breastfeeding, or if a baby has received antibiotics, then these healthy bacteria are killed off and the gut has to recolonise with bacteria. Mothers will often, for example, have been given antibiotics if they have had a Caesarean Section, but may be unaware of that.

Sometimes the balance of bacteria appears to "go wrong" even without antibiotics, for example if there has been a viral infection. Babies/infants can develop colic, excessive wind, diarrhoea and sometimes gastro-oesophageal reflux symptoms. There are ongoing studies about the role of probiotics in allergies and other diseases of adulthood as well. Whilst probiotics are not a drug, many Paediatricians recommend them and many parents also find that they are a useful complement to conventional treatments.

Some parents are choosing to give probiotics on a regular basis as they have read that they might boost immunity, or reduce the risks of allergies. Whilst the evidence for those effects is not very good, probiotics are certainly safe and may be beneficial - a bit like vitamins. There are many probiotic preparations available and choosing can be difficult. My usual advice is to ensure that the preparation is made to high quality standards, does not contain dairy or other potential allergens, contains 2-3 different bacteria (multi-species preparations seem to be better) and that the dose of probiotics is about 2 billion a day.

Should I be worried about my baby's breathing?

"If ever you are worried about your baby's breathing don't delay getting urgent help and advice. Some breathing problems are emergencies and some are not. If your baby has ongoing problems with a cough or seems to be 'chesty', then they need to be examined and they may need other investigations such as a chest X-ray, in addition to any other treatments that might be recommended such as antibiotics, inhalers etc. I see a lot of babies for these problems as it is understandably difficult for parents, especially when their baby is very young, to know what is needed."

When should my baby start solids?

"The answer of course is - it depends, but the fact is that many babies are more than ready for food well before the traditional 6 months of age, and many will benefit from starting solids much earlier. There is emerging evidence that a number of common and important problems, such as reflux and some allergies, may be reduced or even prevented by early weaning. Each baby is different, and therefore a single recommendation is impossible to apply universally."

Should "strawberry mark"-type birthmarks always be left alone?

"Traditionally these marks, which are called capillary haemangiomas, are not treated actively as they tend to reduce and fade over time by themselves. However if they are particularly prominent (for example on the face) or seem to be growing very quickly, there are treatments available that can help to shrink them and prevent further growth."

My baby has a flat head at the back - does it need treatment?

"I see a lot of this condition, called plagiocephaly. Most of the time it is a simple and benign problem, which will resolve by itself without any need for treatment, by using some simple positioning. It is, however, important to check that the scalp sutures (the joins between the different bones of the skulls) are normal and not showing signs of premature closure, which should not happen in babies."

Can I see the growth charts that Paediatricians use?

"Of course! The 0-4 year charts we mainly use are from the WHO and RCPCH ( 2009 Royal College of Paediatrics and Child Health)
Here is the one for boys aged 0-4 years and here is the one for girls aged 0-4 years.

You can also get replacements for the ones in your red book
0-4 years boys,
4-20 years boys,
0-4 years girls,
4-20 years girls"