When I was pregnant, I imagined that my baby would be perfect, with clear skin, shining eyes, glossy hair, smiling mouth and all anatomical parts in working order. Considering my then-recent internship in pediatrics, you would think I’d have known better. But no. Under heavy hormonal influence, I believed both of my babies were flawless. Secretly, I felt sorry for people with lesser versions of the newly minted human.
Hindsight and photo albums provide evidence that my offspring, though spectacular, possessed a few flaws. My son cried a lot, mostly at night. His skin broke out in rashes. Although his 10 strands of hair were quite lovely, he was a nearly bald babe. In contrast, my daughter’s capacity to sleep seemed almost unnatural. Her skin was clear, but her respiratory tract occasionally wasn’t.
As in most children, these run-of-the-mill quirks passed with time. When you’re in the thick of early parenthood, however, some days drag so slowly you may want to snap at the next person who tells you to enjoy these fleeting days of childhood. If you have a colicky baby, you will come to understand the expression, “The years are short, but the days are long.” Nights can seem endless.
At such times, simple home remedies can serve as life savers. If you’re a first-time parent, you might be learning to recognize which mild maladies are easily managed at home. But whenever you’re in doubt, whenever your child seems sick, call your physician. Infants, particularly those younger than 2 to 3 months, can become very ill very quickly. Body temperature isn’t a reliable sign in newborns. Regardless of what the thermometer says, seek immediate medical attention for a sick infant. Alarming signs include extreme irritability, lethargy, convulsions, difficulty breathing and dehydration. Signs of dehydration include dry lips, crying without tears, no urination for eight hours, sunken eyes and a sunken fontanel (the soft spot atop the head).
Now that I’ve terrified you, let me say that all the problems discussed below are minor and generally resolve on their own. Natural remedies can hasten the process.
Clear Up Cradle Cap
This charming name conjures a lacy bonnet and is as apt as calling dandruff fairy dust. The medical name, infantile seborrheic dermatitis, cuts through the euphemism. Cradle cap lacks the benefit of hair cover and is more extensive than dandruff, albeit more transitory. The greasy flakes grace not just the scalp but also the eyebrows and the skin of the forehead, behind the ears, and sometimes the armpits and groin. The exact cause of this inflammatory condition is unknown, but it has to do with an exuberant production of oil, which dries to form yellow, oily scales. The scales plug the oil glands, stimulating them to produce even more oil.
The good news is that cradle cap doesn’t bother your baby. The flakes and crusts will loosen on their own in a few weeks. Less often, the condition can wax and wane over the first year. Do not pick off the flakes or vigorously rub the scalp, which can cause bleeding and irritation.
To speed the healing process, you can massage olive, apricot or almond oil into your baby’s scalp. You also can try a calendula- infused oil (see “Diaper Rash: Soothe Delicate Skin,” below). Leave it on for 30 minutes, then gently run a fine-toothed comb or soft brush through the hair. Afterward, wash off the oil with baby shampoo, rinse and pat dry.
You also can boost the oil with calming herbs, such as lavender (Lavandula angustifolia). Herbalist Kathryn Higgins is the founder of Motherlove Herbal Company in Laporte, Colorado, a company that makes products for pregnant and breastfeeding women and babies (www.MotherLove.com). Her Birth and Baby Oil contains apricot oil infused with lavender flowers.
Mindy Green, aromatherapist and coauthor of Aromatherapy: A Complete Guide to the Healing Art (The Crossing Press, 1995), recommends three essential oils derived from herbs that soothe inflamed, irritated skin: lavender, German chamomile (Matricaria recutita) and Roman chamomile (Chamaemelum nobile). To 1 ounce of carrier oil, you either can add 2 drops of one of these essential oils or 1 drop of either type of chamomile plus 1 drop of lavender. That’s two drops total. (See “Essential Oils: Use Caution” on Page 48 to learn about prudent use of these very potent plant oils in young children.)
Call your doctor’s office if several days of home treatment aren’t helping, if the rash spreads beyond the usual locations, or if the skin begins to look infected.
Diaper Rash: Soothe Delicate Skin
Diaper rash is so common among infants that it’s considered normal. The irritation from the diaper and its contents is too much for most babies’ sensitive skin. There are, however, things you can do to control it.
• Change the diaper frequently: at least every two hours, until your baby begins urinating less often. Compared with cloth diapers, disposable diapers are harder to tell when wet. Poopy diapers are easy to detect. Change these immediately, then gently clean the diaper area with water or an unscented wipe.
• Experiment with different brands of disposable diapers.
• If you use cloth diapers, use breathable covers rather than plastic pants. The latter traps in heat and moisture, raising the risk for a yeast infection.
• When washing cloth diapers, use a fragrance-free detergent to minimize allergic reactions. (Such reactions will manifest as a rash limited to the areas where the diaper contacts the skin.) Add 1/2 cup vinegar, which has antiseptic properties, to the rinse cycle.
• Bathe your baby with mild soap. Gently pat dry. To the diaper area, apply an ointment: zinc oxide, A+D Original Ointment or an herbal salve. Do not use powders, especially talcum powder. Inhaled talcum particles can cause lung disease. Cornstarch can worsen a yeast infection.
• Occasionally give your baby’s bottom a breather — no diaper, no ointment.
• If the rash is concentrated in a ring around the anus, your baby may be allergic to something in his diet. Try discontinuing any recent new foods.
Green’s favorite treatment for diaper rash is calendula oil. Calendula, Green says, “is good for skin care in general. It’s antibacterial, antifungal, mildly antiviral and helps heal burns and wounds.” This oil is an herb-infused oil, rather than an essential oil. You can buy commercially prepared calendula oil at health-food stores (from such companies as Weleda or Herb Pharm). If you make your own, be sure you have calendula (Calendula officinalis), also called pot marigold, and not garden marigold (Tagetes spp.), which is a skin irritant. Place 1 cup of dried, powdered calendula flowers in a clean, dry jar; add enough oil to cover, and cap. Shake daily for at least one week, then strain through cheesecloth or muslin.
Green sometimes spikes calendula oil with essential oils. To 1 ounce calendula oil, add 1 drop geranium essential oil (antifungal) and 1 drop lavender essential oil (mildly antifungal, anti-inflammatory). Although tea tree oil is famous for its antimicrobial power, “this essential oil can irritate babies’ skin and isn’t very pleasant smelling,” Green says.
Higgins treats her granddaughter’s diaper rash with an herbal salve she makes called Diaper Rash Relief. It contains myrrh (Commiphora myrrha) — antibacterial and antifungal; Oregon grape root (Mahonia aquifolium) — antibacterial, antifungal, antiparasitic; calendula — anti-inflammatory, astringent, antibacterial, antifungal; and yarrow (Achillea millefolium) — astringent. Many of her customers send notes of appreciation about this product, which she says also can be used preventively.
Diaper rashes usually can be handled at home. However, call your doctor if the rash becomes extensive; your baby seems uncomfortable; three to four days of home treatment haven’t improved things; bumps and blisters with a honey-colored crust appear (signs of a bacterial infection called impetigo); or small red patches develop, merging to form larger patches.
Bright red patches may indicate an infection with the yeast candida, which doctors usually treat with antifungal creams. The antifungal herbs in the diaper-rash salve mentioned above can help prevent fungal infections. You also can try applying plain yogurt or liquid Lactobacillus acidophilus or L. bifidus (beneficial bacteria found in yogurt) to your baby’s bottom a few times a day. If you’re nursing, you can take an acidophilus supplement. You also should call your doctor if your baby develops thrush, a yeast infection in the mouth, marked by white patches that don’t wipe off. Higgins notes that nursing mothers of babies with thrush can safely apply her Diaper Rash Relief or an acidophilus paste to their nipples.
Colic: Lots of Crying, Elusive Cure
Colic is defined as “excessive” crying (more than three hours a day for more than three days a week) in an otherwise healthy infant. During the first six months, this harmless but distressing condition can trouble up to 25 percent of newborns and their parents. Crying typically is more intense in the evening. Difficulty falling and staying asleep is common. Scientific studies suggest colicky babies aren’t in pain (even though colic derives from the Greek word for pain). Nevertheless, they often look uncomfortable, their faces red, heads raised, legs drawn up to their bellies. The cause is unknown, though many experts suspect nervous system immaturity may be to blame. Compared with their more placid peers, colicky babies typically become overstimulated more easily and have more difficulty unwinding.
As with most conditions of mysterious origins, a cure for colic remains elusive. In 2000, the journal Pediatrics published a review of colic treatments. There isn’t enough positive research to trumpet any one therapy. For instance, only one out of three clinical trials supported the use of simethicone (Mylicon, Phazyme), a drug that can help break up bubbles in the intestinal tract.
Instinct drives most parents to pick up a crying baby. Surprisingly, two out of three studies did not find that increased carrying reduced crying in colicky babies. However, most pediatricians advocate tender responsiveness. Your baby is learning that she can count on your help. Most newborns feel distressed when their arms and legs are flapping about, which is why many feel calmed when wrapped snugly in a blanket or placed in a front carrier or sling.
Experiment with position. Some babies get more relief from being held head up, while others feel better on their backs or tummies. The gentle pressure of your shoulder or legs against her belly may help. Some babies soothe to gentle, rhythmic movement: rocking, swinging, car rides or stroller rides.
Allergies may play a role in babies’ colicky crying, but these infants usually have other symptoms of allergy: eczema, spitting up, diarrhea, stools that test positive for blood (usually microscopic) and poor growth. In bottle-fed infants, hypoallergenic formulas can have a beneficial effect. Switching to a soy-based formula might not help, as 25 percent of these infants also are allergic to soy. A new study published in the European Journal of Clinical Nutrition found that a formula made with hydrolyzed whey proteins and prebiotic oligosaccharides (sugars that support the growth of normal intestinal bacteria) eased colic.
For breastfed infants, it can help if the mother adopts a hypoallergenic diet. That means eliminating such foods as cow’s milk, eggs, wheat and nuts. Some nursing mothers find it helpful to avoid foods that give them gas — typically cauliflower, broccoli, Brussels sprouts, cucumbers, peppers, garlic, onions, beans and other legumes — as well as spicy foods, caffeine and alcohol. During feedings at breast or bottle, the infant’s head should be higher than her belly.
Massage and Herbs for Colicky Babies
Massage can calm your little one. In one study, infant massage and a crib vibrator decreased colicky crying by 64 percent and 52 percent, respectively. Using light pressure, concentrate on your baby’s stomach. Move in circles around the abdomen, starting in the lower right corner of your child’s belly (lower left from your perspective), moving up, under the ribs, then down the left side. Cycling your baby’s legs sometimes helps, too. If you want to use a massage oil, Higgins recommends an apricot oil infused with lavender, which is calming, antispasmodic and carminative (expels intestinal gas).
Although the general rule is to hold off on internal herbs for the first six to 12 months, small amounts of herb tea might bring relief. One study compared giving colicky infants a liquid placebo with giving several ounces daily of herb tea made from chamomile, vervain (Verbena officinalis), licorice (Glycyrrhiza glabra), fennel (Foeniculum vulgare) and lemon balm (Melissa officinalis). With each colic episode, parents offered their baby the tea or placebo drink — up to about 5 ounces at a time, not more than three times daily. The tea eliminated colic symptoms in 57 percent of infants, whereas the placebo treatment helped only 26 percent. Fennel, vervain, chamomile and lemon balm relax the intes-tines; the latter three herbs relax the ner- vous system. Licorice is anti-inflammatory and soothes mucous membrane linings.
Other time-honored herbs for colic include catnip (Nepeta cataria), dill seed (Anethum graveolens) and caraway seed (Carum carvi). Anise seed (Pimpinella anisum) also is on the list, but avoid star anise, which has been linked to two cases of poisoning. In one case, Chinese star anise (Illicium verum) was contaminated with Japanese star anise (Illicium religiosum), the latter of which is neurotoxic. To avoid any confusion, Green prefers to use fennel rather than anise. She also advises parents to stay away from peppermint (Mentha ¥piperita), which eases cramping and gas in adults but is too strong for babies; spearmint (Mentha spicata) is milder. Also note that some people are allergic to chamomile.
To make tea, boil water, turn off the burner, add the herbs (1 teaspoon of dried herb per cup for adults; 1/2 teaspoon herb for babies), steep 10 minutes, strain well and cool until the liquid is comfortable on your inner wrist. Make a fresh batch each day. You can give your baby the tea with a sterilized dropper. If your breastfed baby balks, try holding the dropper next to your nipple. DO NOT sweeten the tea with honey — it’s not safe for infants younger than 12 months.
A caution: Don’t overdo supplemental liquids; they take the place of breast milk or formula, which your baby needs to grow. Furthermore, you risk reducing your breast milk production. A safer alternative for nursing mothers is to drink tea made from the aforementioned herbs several times per day (1 cup three times a day).
Warmth in general helps some babies. Los Angeles physician Lauren Feder recommends hot water bottles. Check that the temperature is warm, but not hot, and keep a cloth between the water bottle and your baby’s skin. Higgins adds that you also can buy or make small herb pillows that contain anti-colic herbs. Manufacturers recommend warming them in a microwave. Test the pillow on your own skin to make sure it’s warm but not hot.
In my experience, warm baths can help. My perpetually ravenous son quieted if I got in the bath with him and nursed. Because many herbal constituents are absorbed across the skin, you also can decant anti-colic tea into the baby’s tub. Green recommends adding a handful of catnip and lemon balm to a quart of water. Steep until lukewarm (at least 15 to 20 minutes). If the mixture is still hot, add cold water before straining into the tub.
Teeth begin to push through the gums around the fifth or sixth month of life. Be suspicious when your baby, who has given up colicky crying and has generally become more organized and predictable, starts to fuss. As a parent, one challenge is differentiating teething from something else, such as a middle ear infection. The other hurdle is making your bundle of love feel better.
In a research study published in Pediatrics in 2000, researchers went to the trouble to clarify symptoms and their duration. Signs of teething included “biting, drooling, gum- rubbing, sucking, irritability, wakefulness, ear-rubbing, facial rash, decreased appetite for solid foods and mild temperature elevation.” These behaviors emerged about four days before the tooth broke through and continued another four days. Eight days total. Despite what your friends might tell you, signs that are not associated with teething are “congestion, sleep disturbance, stool looseness, increased stool number, decreased appetite for liquids, cough, rashes other than facial rashes, fever over 102 degrees and vomiting.”
Chewing on something cold often eases the pain. You can offer your baby a frozen washcloth, frozen bananas or bagels, or chilled teething rings — just make sure your baby gnaws on something nontoxic and without small parts he could choke on.
All Grown Up
My two children are now at the brink of adulthood. The amazing thing is that, after all these years, I still think they are beautiful, brilliant and generally fabulous human beings. Please don’t remove the wool from my eyes.
Linda B. White, M.D., is the coauthor of Kids, Herbs, & Health (Interweave Press, 1999) and The Herbal Drugstore (Rodale, 2001). She teaches botanical medicines and other courses at Metropolitan State College of Denver.