Babies health care, (Part Two)

Q: What do you recommend doing about cradle cap — those scaly patches that babies sometimes develop in their hair or on their face?
A: Cradle cap is a form of seborrhea. It is a skin condition caused by some of the sweat glands in the scalp overworking. And even though it is called cradle cap, it can occur on the eyebrows and behind the ears, as well as on the scalp. It can become a problem for two reasons: first, sometimes parents see a flake and think it is dry skin, so they put a lot of lotion on, which makes it worse and leads to more flakes. Second, sometimes cradle cap gets worse because parents are not washing their baby's hair frequently enough. I often hear parents say that since the soft spot is not closed, it is dangerous to wash the baby's head, which is not true. If your baby has cradle cap, try washing his or her hair every other day with baby shampoo. If it doesn't get better, try rubbing a little baby oil or mineral oil into the scalp to loosen the flakes. Then use a comb to gently get out some of the flakes, followed by a wash with baby shampoo. The important thing about using lotion or baby oil is that you need to wash it out within 24 hours. Otherwise, it will make the cradle cap worse. If none of this works, you can try adult dandruff shampoo, and if that doesn't work, you can talk to your pediatrician. Cradle cap isn't usually painful for the baby, although sometimes a parent tries to scrape it off and causes a little bleeding, which can be irritating.

Q: Since baby skin is so sensitive, do you need to use a special detergent when washing their clothes?
A: I'm not sure that's really necessary, although there is certainly nothing wrong with those special detergents. For new clothes, I always recommend that you wash them and put them through the rinse cycle twice. If you do that, it doesn't matter what type of detergent you use because the clothes will have been rinsed thoroughly. I do recommend that you wash all new clothes before you put them on your baby.

Q: It seems like every baby encounters a diaper rash at some point. What can you do to minimize those?
A: The common causes of diaper rash are irritation of the skin or a yeast infection. Try to avoid diaper rash altogether by changing baby's diaper frequently. The more often you change their diaper, the less likely diaper rash becomes. I recently heard a dermatologist say that babies rarely get a diaper rash if their diapers are changed eight or more times a day. That will help avoid a rash caused by irritation. Once you notice the area getting irritated, there are a few things you can do — besides frequent diaper changes — to help reduce irritation. First, avoid using baby wipes and instead use soap and water — baby wipes often have alcohol, which irritates the skin. You might even want to carry a wet washcloth in your diaper bag instead of wipes if your baby is starting to get a rash. Also, let the diaper area air-dry as often as possible. Finally, if the area is getting red, try any of the over-the-counter diaper rash products that contain zinc oxide. Just make sure you are using them properly. They are a thick paste that is meant to be slathered on to form a barrier for moisture. Do not wipe the paste off with every diaper change. If you do, the area will just become more irritated. Just wipe the wetness of the diaper and stool off with water and then apply more paste. You want to leave it on for at least 24 hours. After two or three days, the rash should go away. If not, see your pediatrician. It may be a yeast infection, which can be treated with a prescription medication.

Q: Let's move on to fingernails. What's the best way to keep baby's nails short and snag-free?
A: It is recommended that they either be filed down with a gentle nail file or clipped with manicure scissors. Try not to cut them too close to the skin, and try not to use nail clippers. Even though they're really careful, I've seen too many parents clip off the tip of their baby's finger, which isn't surprising considering that babies are usually pretty squirmy. I think filing with a gentle nail file is really the way to go.

Q: Part of keeping baby comfortable ties in to how you bundle up your little bundle of joy. What do parents need to know about how to dress their baby?
A: Dress your baby the same way you dress yourself. If it's winter, you want to make sure that baby has an undershirt on and his head is covered. If the house is warm, he might just need the undershirt and one other layer of clothing. If not, he may need more. In summer, one layer of light clothing will do. Whatever level of dress would keep you at a comfortable temperature is the proper level of dress for your baby. They don't feel cold more than adults, so they don't need to be bundled. One thing I see a lot of parents do is put a big old wool blanket over their baby's head when they go out in winter, thinking that will help keep the wind and cold off of baby. I'm more worried about suffocation when I see that. If you must cover baby's head, use a light receiving blanket. And be sure to check baby frequently to make sure he or she is OK.

Q: What about footwear? Do high-end shoes help baby's feet, or will a cheap pair of kicks do the trick?
A: A lot of parents ask if babies need to wear shoes at all. The answer is yes, and the reason is that shoes help keep baby's feet warm and help prevent them from injuring themselves if they step on something sharp. But hard-bottomed shoes are no better than soft shoes and in fact they can be dangerous because they can be slippery on wood or linoleum floors. So rather than spending $30 or $50 on a pair of shoes, just buy an inexpensive pair of sneakers that have a good grip and will keep baby's feet covered. They don't need special arches or ankle support; you just need to make sure they fit well and are not pinching your baby's toes. And when baby is learning to walk, it may actually help for him or her to be barefoot. Wearing shoes can sometimes dull the sensations that help babies learn to keep their balance.