The Things That Newborns Do…..

 

I really enjoy the newborn visit. Usually, two days after discharge the proud parents and tiny baby come in for the first office visit. This is to monitor the baby’s weight as well as to check for jaundice. The parents are beaming with pride, yet are a bit apprehensive of the unknown. This new human life is truly a miracle, but seems so vulnerable and helpless…it can be a daunting task. The parents are ready with the infant carrier, diaper bag and voluminous notes about the feedings, stools and number of voids.

 

After going through a detailed history and answering all the questions that the parents might have, I then ask, “Does your baby sneeze or have hiccups?”.

 

Inevitably both parents pause as if they had been zapped. They look at each other, smile and then say, ”Oh my gosh, yes! We were meaning to ask you about this!”.
 

I go on to explain that both hiccups and sneezing are normal reflexes that occur in all newborns.

 

Hiccups are a reflex that occurs when the baby’s stomach is full from either feeding or crying which may cause the baby to swallow additional air. This expanded stomach presses on the diaphragm that sits on top of the stomach. It is thought to cause mild irritation of the diaphragm, which is a muscle. When this happens, the muscle is caused to spasm, which develops hiccups. Pregnant moms can tell you that their fetus often gets hiccups while in utero. Moms can feel them without question. This happens because the unborn fetus is constantly swallowing the amniotic fluid. The stomach then fills and expands, and presses on the diaphragm. This triggers the hiccup reflex.

 

Hiccups in a newborn are not dangerous or bothersome to the baby.

 

I feel they concern the parents and grandparents more than the infant. Should they occur, it is a good idea to position the baby upright and try to get a burp out. Frequent burping may help. Some people feel that stimulating the palate might be a way to turn the hiccups off through a different reflex. Using a pacifier for this may be helpful. Nonetheless, hiccups in a newborn are self-limiting, benign and nothing to be worried about.
 

Sneezing is another normal newborn reflex that can cause much angst for parents and grandparents.

 

Babies are predominantly nose breathers for the first couple months of life. They CAN adapt to mouth breathing if they have to, but they almost exclusively breath through their noses. As such they have a very important reflex that insures the nasal passages and airways are clear and open. When a newborn gets anything in or around the nose such as dust, lint, mucus, fuzz or hair, this stimulates the sneeze reflex. The baby will sneeze two-to-four times and it can be forceful and impressive. The baby can be comfortably sleeping in your arms, happy as a clam, and then let out three loud sneezes that come out of nowhere. Then fall back to sleep. This is normal and does NOT mean that the baby is sick or coming down with a cold…contrary to what some family member might opine. It may be helpful to raise the head of the bassinet to around 20 degrees and to run a cool mist humidifier. If there is mucus in the nasal opening it can be suctioned out with a bulb syringe. But I always tell parents to only try to suction out what they can see. Don’t blindly try to stick the bulb syringe up in the nose. This may irritate the area and make matters worse. And it will invariably make the newborn VERY mad.
 

Most parents who come in for the newborn visit are usually appreciative of our talk on hiccups and sneezing.

 

Although they have only been home for two days they have had countless suggestions and concerns from well-meaning family members or friends. Suggestions on what it might be and what they should do about it. While the main focus is on the feedings, stooling and voiding as well as sleep…or lack thereof, sneezing and hiccups are those “Oh yeah, I meant to ask about that” topics that are often overlooked.