Nappy rash, colic and crying: 23 things for every parent with a newborn to know

After 10 years as a GP, Dr Fiona McGuire is now a senior medical officer with the HSE Department of Public Health in the Midlands. She has reviewed information for the HSE's My Pregnancy and MyChild books, and the mychild.ie website. She has two small children. Here she shares some advice for mother and baby after birth.

• Remember that your body has been through an endurance event. No matter what way you gave birth your body needs time to recover and heal.
  
• Nothing can prepare you for the reality of becoming a parent, even being a doctor. I'd done 100-hour shifts so thought I'd be well able for the sleepless nights, but it's different.
  
• The baby blues are normal. Over 80 per cent of women get them about 3 days after giving birth. However, if they last longer than two weeks tell your GP or Public Health Nurse. Post Natal Depression can present up to a year after birth. Symptoms include feeling down, crying easily, worrying constantly about your baby, and feeling exhausted but unable to sleep.
  
• Even once the visitor restrictions of the pandemic are lifted, you should still ask anybody who is unwell not to visit you in these early weeks. And it will still be reasonable to ask visitors to wash their hands with soap and warm water before holding your baby.
  
• The coldsore virus can be very dangerous for newborns. To protect them, no one with a coldsore – or who feels one coming on – should kiss your baby, including you.
  
• Ask for help. You need time away, for a shower, a quick walk, to eat, to rest in bed. You can't care for anybody else if your own needs aren't being met.
  
• Painkillers can help with after-pains, cramps caused by the womb contracting back to its pre-pregnancy size. They may feel particularly sharp during breastfeeds. If you haven't received a prescription ask your pharmacist. If they feel more severe than bad period pains, tell your GP or PHN.
  
• Bleeding for up to 6 weeks is normal. Maternity pads need to be changed often. If the amount of blood increases, or you pass clots, seek medical advice.
  
• Bad odours or green discharge from your perineum or caesarean wound are signs of infection, and need to be checked straight away.
  
• Begin your pelvic floor exercises again. You'll find instructions on mychild.ie.
  
• Leaking urine or faeces after giving birth is quite common. However, if it doesn't improve within six weeks tell your GP or PHN, for referral to a woman's health physiotherapist. Don't be embarrassed. We've seen it all.
  
• Other women will be constipated. Drink loads of water and eat high fibre foods. To make your perineum, and any stitches, more comfortable when you poo, put a clean pad to the side of your wound and press gently.
  
• Newborn skin is sensitive. Wash initially with plain water, and then avoid per-fumed products. If your baby has eczema use a little aqueous cream instead of soap, but never as a moisturiser.
  
• For nappy rash to heal, the skin needs to be clean and dry. Change more often, clean from front to back, and use a cream. Time without a nappy will be beneficial. If it's very red and angry, and keeps spreading, go to your GP; your baby may have thrush, or require a medicated cream.
  
• Babies with thrush in the nappy area may also have thrush in their mouth – a white coating or plaques. Your GP can prescribe treatment. If breastfeeding you may also need treatment. Thrush can spread to the nipples, making them sore, and interfering with feeding.
  
• Crying is the only way for your baby to tell you they need something. You're not "spoiling" a baby if you pick them up and hold them when they cry; you are helping them feel safe. Being responsive to a baby in the early months improves their emotional regulation development.
  
• Colic is when your baby cries more than three hours a day, more than three days a week, for more than three weeks. They go red in the face, and may draw their legs up. Suggestions include winding for longer, a warm bath, or gentle massage, but babies with colic are often inconsolable, which is very difficult for parents. Tell your GP if it is affecting your mood. If you are formula feeding never change formula without consulting your PHN or GP, as this can upset their digestive system.
  
• If your baby isn't feeding well, seems to be in pain, and arches their back during and after feeds, these may be signs of reflux. Tell your GP. There are things to help them feed and feel better. Changing breastfeeding positions can even help.
  
• Babies who are not having 3-4 wet nappies per day might be getting dehydrated. Other signs of dehydration are if the soft spot on the skull – the fontanelle – starts to become sunken, or if they are listless and lethargic. Keep feeding and seek medical advice.
  
• Harmless spots are common in newborns but get your PHN or GP to check any rash. Press a glass on top of the rash. If you still see it through the glass this is possibly a sign of serious infection. Get medical help straight away.
  
• Other reasons babies need medical attention include: being extremely lethargic or not responding normally; not feeding well, or losing weight; vomiting – particularly projectile vomiting – or blood or green bile in their poo or vomit; a blistering rash; jaundice – where the skin or white of the eye has a yellow tinge; a high or low temperature. In a baby under the age of three months this is less than 36.5 degrees, or 38 degrees and higher; and for babies between 3-6 months 39 degrees and higher.
  
• For accuracy always use an underarm digital thermometer. If they're just out of a warm bath, or very warm clothing, let them cool down first. Lie them on their back. Put the thermometer under their arm and gently hold their arm against it.
  
• Never be afraid to ask for medical help. Trust your instincts, and be confident in them. Get a second opinion if you feel your concerns are not being listened to. As a GP I have learned to ignore a mother at my peril. Parents know their babies better than anybody else.