QUESTION 4

My son is now 10 weeks and 6 days old. I noticed about 3 weeks ago that he had developed a flat spot at the back of his head and it has since grown larger. He has been using a pillow that purportedly minimises the risk of plagiocephaly. He sleeps in his infant car seat in the day and his cot at night. As he is a very light sleeper, I have not been able to reposition him. He does not like to lie on his side and does not like tummy time. Any advice?

Jillian Lim Pok Yeng
 

ANSWER:

Dear Jillian,

Unlike adults, a baby’s skull is made of plates of bones joined together by a thin membrane and suture lines. An example of this membrane is the soft spot on the top of Max’s head. These membranes are necessary so that the head can grow, and they will usually harden by the time he is two years old.

During this time, it is common for a baby who sleeps in the same position to develop an asymmetrical head shape. This is temporary and will improve naturally as he grows up. You can minimise it by trying to rotate his sleeping position. This will probably become easier as Max grows older. Perhaps you may like to try not using your pillow and letting him sleep facing sideward.

There are several genetic conditions called craniosynostosis where the skull is deformed due to premature hardening of specific suture lines. However, these conditions are rare and often associated with other specific features. Your paediatrician will alert you if Max has this condition.

– Dr Lim Kwang Hsien

QUESTION 5

My daughter is just 3 months old and is fully breastfed. Her bowel movement was normal – many times in a day – for the first month, slowly becoming once a day when she reached about 1 month of age. However, the past few weeks have been quite stressful for me as she only moves her bowels every 6 or 7 days. And when she finally does, the stools are watery and sometimes seedy. There is no hard stool and it is mustard yellow in colour. She appears okay though. There’s no tiredness or crankiness and she drinks her milk well. Is there a cause for concern? Also, is there anything I can do to help her move her bowels more often?

Kathleen Ho
 

ANSWER:

Dear Kathleen,

Breastfed babies often have varying stool habits. Some may poo many times a day, while others may not for up to 10 days. Don’t be too stressed about it as long as Shayna is thriving well and is not distressed by her irregular poo habit. Your warning signs are:

1. Blood in the poo
2. Hard stools like pellets associated with difficulty passing motion
3. A distended tummy
4. Failure to thrive

Some techniques that might help Shayna poo include gently massaging her tummy, tickling her anus with either a cotton bud or wool while keeping her legs bent to her knees, or exercising her legs like riding a bicycle. Sometimes, a short course of oral laxative may be useful. Do consult your doctor if Shayna has any of the above warning signs or if her bowel habits worsen.

– Dr Lim Kwang Hsien