Fear is a natural emotion among parents, and fear that their precious child may come to harm or injury or succumb to illness can cause desperate worry for even the most level-headed of moms and dads.
Knowing what to do to help prevent the dreaded from happening and how to react should it become a reality ought to be at the top of the list of essential parenting know-how.
Although it can feel like there’s an awful lot to take in – in addition to all the other new-parent skills you need to acquire in the early days – getting a good handle on the key essentials will give you enormous peace of mind.
1. Save him from choking
Choking is a common worry. Alice Walsh, a paediatric health and safety trainer, says what might appear to be a choking infant may not be, especially when babies are just starting on solids, learning how to eat and swallow and are developing their reflexes.
"Sometimes, food may appear to have gone down the wrong way, but hasn't - babies will cry, cough, splutter, go red in the face, their eyes will water, but if they're crying, they're not choking," she says, adding that a few gentle slaps on the back should bring up what they've probably got stuck in their foodpipe. She adds: "But if a baby is not crying and he is going blue, then he is choking."
If this happens, have someone call an ambulance. The Heimlich manoeuvre is necessary, and although training in the procedure, with demonstrations on dummies is by far preferable, here are the basic steps:
• Turn your baby down with his head supported by his chin between your open thumb and forefinger (not around the neck) and with his body running the length of your forearm.
• With the heel of your free hand, give him five robust claps between the shoulder blades.
• If that doesn’t dislodge the obstruction, turn your baby over so that the back of his head is supported in the palm of your hand.
• Jab two fingers firmly into his abdomen five times, halfway between his belly button and the triangle of bone in the centre of the chest below the lungs.
• Turn your baby over and repeat the steps if necessary, and don’t be afraid to apply a little more force.
Choking is better avoided, so keep small swallowable items such as buttons, coins, etc away from babies. “To eat, babies should be sat up in a chair and not distracted by anything,” says Alice. “Soft food, with solid food chopped small and kept moist is the way to go, with plenty of fluid. Avoid feeding big and dry lumps of food.”
2. Watch out for allergic shock
Anaphylaxis is a severe allergic reaction, the symptoms of which may include wheezing, sweating, swelling and rashes - especially around the lips or face - diarrhoea or vomiting, floppiness, a faint pulse and loss of consciousness.
It is extremely rare in babies under six months, as most allergies - especially food allergies - tend to develop in toddlerhood. Foods such as dairy, eggs, wheat, soya and nuts are typical triggers, as well as latex, medication and insect stings.
It is unusual for a first allergic reaction to be serious, so it is likely you’ll have had a prior warning, had your baby’s allergy diagnosed and been advised on what to do.
To handle a suspected anaphylactic reaction, the key message is to keep calm, call for an ambulance at once, lie your baby down with his feet up, and don’t try to feed him anything at all, as he may choke. Paramedics may give him an injection of adrenaline when they arrive, and he should recover fully.
3. Know how to handle wounds and bleeding
Never remove anything embedded in a wound, such as a shard of glass, as you can do more harm and increase blood loss. “Wrap and pad the affected area with bandages, tea towels, handkerchiefs – anything you have to hand,” says Alice.
“Obviously, it’s better if you have clean material, but in an emergency it doesn’t matter – if it’s dirty any infection a child catches can be treated later.”
If you are sure that nothing is embedded, apply firm pressure to the area of the cut with gauze or tea towels to stem bleeding, and elevate the site of the wound. Then, seek medical attention at once.
4. Have him immunised
Fact: immunising your child offers the most important protection from life-threatening illnesses. According to the World Health Organisation, a 95 percent uptake of vaccines is needed to prevent outbreaks recurring.
“Immunisation is completely safe,” says Dr Brenda Corcoran, a consultant in public health medicine. “Parents can be reassured that there is no evidence for any association with the vaccine for measles, mumps and rubella, and autism or bowel disease. And although minor adverse reactions to the jabs – like sore arms, redness, irritability, mild raised temperatures – are possible, more serious side effects such as allergic reactions are extremely rare.”
But with more vaccines seemingly being added to the schedules in childhood vaccination, won’t additional jabs further overload an infant’s system to breaking point?
Dr Corcoran says vaccines’ safety record is high: “Obviously it’s distressing to see children receive injections but it’s much worse to see them acutely ill with a very serious infectious disease which could’ve been avoided. That’s what it all boils down to.”
5. Watch out for meningitis
Sudden and potentially life-threatening, meningitis is one of the most feared diseases. Simply, it is an inflammation of the membranes that surround and protect the brain and spinal cord, and is most dangerous when caused by bacteria.
“Children under five are most at risk,” says Lisa Slattery, a community services nurse working in the field of meningitis. “But especially babies under one, as their immune systems are still developing, and less able to fight bacteria.”
The good news is that some forms of meningitis are preventable and vaccines against them are available. But because not all forms of the disease are covered, it’s essential you are aware of the symptoms.
These include feverishness, cold hands and feet, a stiff neck, an arched back, drowsiness, pale blotchy skin – and possibly a distinctive rash which does not fade under the pressure of a glass (a sign of meningococcal septicaemia, or blood poisoning, a very serious symptom).
Lisa says key danger signs are rapid changes and newly emerging symptoms over a period of a few hours. Remember that not all symptoms will be present: “The characteristic rash, if it comes, can start anywhere, even in places you may not think of looking, like buttocks or soles of the feet, or palms of the hand.
But never ‘wait’ for the rash to appear if the other symptoms are strong. Act at once.” Trust your instincts, and take your child to the hospital or your doctor if you’re in any doubt.
6. Prevent him getting dehydrated
This can happen during very hot weather, in feverish children, or when they're suffering from diarrhoea or have been vomiting. Babies are particularly at risk.
Signs include: dark yellow urine, no urination in the last six hours, fewer than half a dozen wet nappies in the previous 24 hours, lethargy or lack of playfulness, a sunken soft spot (fontanelle), and dryness of the mouth.
Paediatric dietitian Margot Brennan says young babies are capable of “self-regulating” their ?fluid intake, taking
what they need and stopping when they need no more, but that during warm weather they may need extra. Frequent feeds should be offered. Babies of over six months can also be given boiled and cooled water in addition to their formula or breastmilk.
“One good long-term indicator to look out for is constipation,” she advises. “If your baby is normally regular, and suddenly becomes constipated, that could indicate dehydration. Be aware that too much formula milk can cause constipation in itself, as milk is quite high in solutes and salts, so some water is important too.”
7. Keep your eyes open for liver disease
It may not be a duty you like to dwell too much on, but checking the contents of your baby’s nappy could save his life.
About 20 percent of babies are born with jaundice – with its characteristic yellowy skin caused by excess of bilirubin (a bile pigment) in the blood, produced when the liver has to break down the red blood cells which babies are born with. Encouraging greater feeding can help clear up jaundice, and he may need some time under a phototherapy lamp, but if jaundice persists for over a fortnight, it could be a sign of liver disease or a thyroid problem.
You can get a further clue about possible liver disease by keeping an eye on his nappies.
Catherine Arkley, a leading authority on paediatric liver disease, says: “There is no specific group at risk of liver disease. It could strike any family, at any time, so it is important that everyone remains alert to the signs, which are easy to spot. A healthy newborn’s urine is usually colourless, whereas the stool should be English mustard yellow or green in bottle-fed babies, and daffodil yellow or green in breastfed babies.”
Report any deviation – that is, pale stools and/or yellow urine – to your clinic sister or doctor.