Children, especially Infants, are unique in medicine! They may
appropriately display certain signs and symptoms considered abnormal later
In their lifes. In fact, not displaying some of these "abnormal" behaviors
may even be abnormal In some situations. Confusing? The following examples
illustrate some situations where "abnormal" signs and symptoms are clearly
Jaundice in Newborns
Although clearly abnormal in adults, newborn infants develop jaundice
shortly after birth. Except for jaundice in extreme ranges, this yellow
color is more normally present than absent. For additional information see:
do many newborns become jaundiced after birth? and
causes newborn jaundice?
Toxic Erythema of the Newborn
This sinister sounding rash is not only completely harmless, but
seems to only occur in healthy, full term infants. This rash develops shortly
after birth and consists of red blotches in a random distribution all over
the infant. Most blotches have a central yellow-white pimple. The rash comes
and goes and frequently changes location. It may last 2-3 weeks and spontaneously
disappears. For additional information, see:
Actually, blood in the urine is always abnormal. However, infant
s urine may normally contain significant amounts of uric acid. These crystals
get trapped in the diaper liner and appear like red brick dust. If the "blood"
in the urine has this appearance, it is probably not really blood but uric
Menstrual Period In a Female Infant
Several days after birth female infants frequently have vaginal bleeding
lasting one or two days. Maternal hormones crossing the placenta stimulate
growth in the Infant s uterine lining. This hormone stimulation is abruptly
terminated at birth. This causes slough ing of the hyperdeveloped uterine
lining of the baby. The result is the same withdrawal bleeding experienced
by adult women, an infant menstrual period. Normal.
Breast Development in Infants
All boys and girls are born with their breasts developed. This is
caused by maternal female hormone crossing the placenta and stimulating the
baby s breast to grow. The closer to term the child is born, the more pronounced
is the degree of breast growth. The breast stimulation peaks shortly after
birth and disappears in 2-4 weeks. Normal.
Breast Milk in Female Infants
On occassion, female infants will produce a drop or so of breast
milk a few days after birth. Some have called this witches milk. Once again
the pregnant women s extremely active hormone factory is busily stimulating
all that it can. Normal.
Sneezing is one way infants clear their nasal passages. If sneezing
is unaccompanied by runny nose, coughing, acting ill, and not present in
frequent spells, ignore this symptom. Normal.
This behavior usually drives parents nuts, but when doctos walk in
a examining room and see an infant with hiccoughs, we are delighted. This
means we will be able to do all my examination without the child crying.
Infants with hiccoughs are usually in a quiet, alert state and seem curious
about their surroundings (or perhaps while they are hiccoughing). Nothing
needs be done about this unless the hiccoughs have been there very long and
the child is tiring of its presence. A small warm feeding (preferrably breast
milk) usually stops the episode. For more information, see
causes newborns to have the hicccoughs?
Most infants spit up part of their milk feedings. Sometimes the amount
regurgitated is so large that parents begin wearing rain garments. Infants
that have this fountain-like trait often continue spitting until they are
upright (9-12 months). When is this abnormal? In general, ifthe spitting/vomiting
is associated with a happy, growing infant, if no illness (such as pneumonias,
wheezing,etc. is caused by this trait, and if the child looks normal when
the spitting! If vomiting is present (not pale, pasty, sick-looking), you
are probably dealing with a "wet" child. For additional information to determine
when vomiting might be a problem, see
is Pyloric Stenosis? and
Babies Spit up Frequently
Most infants have occassional, short episodes of eye crossing in
the first 3-4 months. Normal. Caution: if the episodes increase in length
of time or severity, or if the episodes do not disappear by 4 months, an
examination is necessary. Because of the infant s wide nasal bridge, a "false"
turning in of the eyes seems present in some young children. Parents should
check and see if light reflects symmetrically in both eyes. If it does not,
a physician should examine the child. For additional information, please
an Eye on your Child's Vision and
Vision Problems Early Saves Sight
The combination of torque placed on the infant s legs during fetal
development and the normal presence of externally rotated hip joints causes
bow legs in infants. In fact this bowing is normal and persists until about
18-24 months of age. Normal. Caution: If the bowing is extreme (you can drive
a freight train between theft knees when they are standing with ankles touching),
if Improvement is not present by 18-24 months of age, or if pain is present,
check it out.
Almost all infants have flat feet. The foot arch may not develop
significantly until 4-6 years. Normal. Caution:
So, when friends point out one of these abnormalities in your child,
smile and say, "My child is normally abnormal."
The above weas adapted from an article written by pediatrician
Harry Pellman and originally appeared in the parenting newsletter Pediatrics