Well-baby checkups are usually happy occasions -- you find out that your little one is thriving, that she's on-target (or ahead of the curve!) with her milestones, that she's just the cutest thing the office nurse has ever seen. But once in a while, the pediatrician will pick up on something that's not quite right. That can be freaky -- but the fact is, even the scariest-sounding symptoms rarely turn out to mean that something's seriously wrong. Here are six of the most common ones and fear-calming information about each.
It's good my doctor was so observant about Molly's hips, even if it did scare the bejesus out of me. About one in 1,000 babies has dislocated hips, or developmental dysplasia, says David Roye, Jr., M.D., chief of pediatric orthopedic surgery at the Morgan Stanley Children's Hospital of New York Presbyterian. "This can be anything from a joint that's dislocated at birth to movement that's so subtle, it won't be noticed until age fifty, when the person starts having hip pain." Risk factors include being a firstborn, female, breech, and having a family history of the disorder.
Fear-calming facts: This condition is totally treatable. If it's picked up before 3 months, the success rate of a brace or harness is 95 percent. A baby under 6 months will most likely wear a harness for 6 to 12 weeks; some may require a cast, and an older baby may need corrective surgery. But, says Dr. Roye, the outcome after any of these approaches is excellent.
Bridget Gilfeather of Pleasantville, NY, had to be fitted with a harness not long after her 6-week checkup. "I was very upset, thinking of all the things she couldn't do, like go in the baby swing," says Bridget's mom, Mary. "Plus, she had to sleep with her legs up! But she adapted easily." By 9 months old, Bridget was out of the harness; by a year, she was walking.
Not gaining weight
Although babies typically double their birth weight by 4 months and triple it by 1 year, some experience "failure to thrive." Despite the horrifying (not to mention guilt-inducing) label, this diagnosis isn't nearly as ominous as it sounds.
Fear-calming facts: A swerve off the normal growth curve can happen for a variety of temporary, treatable reasons, says Andrea McCoy, M.D., chief medical officer at Jeanes Hospital, in Philadelphia:
A skimpy diet. A baby who's exclusively breastfed may not be getting her fill at each meal, but if she's the laid-back type and doesn't fuss about it, you won't know. Most likely, Mom's milk production is at an ebb for some reason (undereating herself? overexercising? stressed out?); a lactation consultant can help. Meanwhile, check with your doctor about supplementing with formula.
Gastroesophageal reflux. It's a mouthful -- just call it GER -- but it simply means a baby spits up so much that she doesn't down enough calories. Most infants do bring up a bit of dinner after eating -- the muscle between the esophagus and the stomach is loose, plus, young babies spend most of their time in a horizontal position, which makes it easier for fluid to flow back. By around 6 months, the muscle tightens, babies sit up more, and GER goes away (although some kids still spit up at 9 months and beyond). The fix until then: frequent burping, holding a baby upright for 20 minutes after she eats, and offering her small, frequent meals.
Genetics. A baby who was hefty at birth may lose ground on the growth chart as her first birthday approaches simply because she's programmed to be a slender person. But check with your pediatrician about any growth concerns.
When your doctor puts her stethoscope to your baby's chest, she should hear a steady series of "thump-thumps." An extra noise, like a squishing or blowing sound, indicates a heart murmur. It's something that may need to be investigated -- typically with a chest x ray or an electrocardiogram. But, says Dr. McCoy, "Heart murmurs are common in babies, and almost all of them are innocent." Plus, the vast majority of serious pediatric heart problems show up within weeks of birth.
Fear-calming facts: During a baby's first 12 months, a heart murmur may be caused by a small abnormality that will resolve without treatment, explains Dr. McCoy. The most common, a ventricular septal defect (VSD), means there's a small hole in the heart wall separating the large chambers, or ventricles. Typically, VSDs close on their own by the time a child's first birthday rolls around, so a baby with one just needs to be monitored closely.
That's how it worked for Micheal Fullhart of Terre Haute, IN. After his 6-week checkup, his parents were told that one of his heart valves hadn't closed properly. He went through a ton of tests, but eventually his heart healed by itself. "All it needed was time," says his mom, Donna. "Micheal's in kindergarten now, and his teachers say he's one of the brightest kids in the class."
Early on, crossed eyes are nothing to worry about, says Ari Brown, M.D., author of Baby 411. New babies' eye muscles aren't fully developed, so the eyes don't track together. By 3 months, both peepers should be moving in sync.
If by 6 to 9 months your child's eyes are still out of whack, however, she may have strabismus, a condition that affects roughly one baby in 100. Strabismus must be treated; if it's not, it can lead to amblyopia, or lazy eye, in which one eye becomes permanently weakened.
Fear-calming facts: Strabismus is easy to correct. Although some kids need surgery, most require little more than patching the stronger eye so that the weaker one gets a good workout. Often a child will need glasses as well.
When a baby boy's scrotum looks disproportionately large, it typically means one of two things: He's got either a hydrocele, a condition caused by extra fluid in the scrotum, or an inguinal hernia, in which a small section of his intestine is protruding into his scrotum. To a parent, the conditions look similar; the pediatrician can suss out which a baby has simply by shining a light on his nether regions. Fluid will show up as light in color, while a hernia will look dark.
Fear-calming facts: A hydrocele will usually disappear by 6 months to a year -- case closed. And even though an inguinal hernia is a bit more problematic, it's rarely painful and is easily fixed with a minor operation, explains Margaret Collins, M.D., a pediatrician in Mt. Kisco, NY. Premature infants are at an increased risk for an inguinal hernia.
Pigeon toes and bowed legs
Your baby's feet turn inward, or your brand-new walker saunters like a cowgirl. This can be worrisome, since we're accustomed to the notion that feet and legs should be straight.
Fear-calming facts: Although it was trendy 30 years ago to have tots wear corrective shoes or braces, now we know better: Pigeon toes, or "intoeing," and bowed legs are both physiologically normal for babies, says Dr. Roye. "Both conditions will improve as the child starts to walk, and by the time she's two and a half, they'll most likely disappear completely." If it persists beyond this age, see your doctor.
Rosemary Black is an editor at the New York Daily News and a mom of seven.