While the majority of babies manage to avoid complicated health concerns during their early months of life, all newborns are susceptible to a range of preventable illnesses, environmental hazards, sleeping difficulties, and issues related to feeding and nutrition. For the sake of their long term wellbeing, newborn infants should be assessed by a paediatrician and screened for congenital and inherited indicators. Hospitals will usually provide this service as a routine component of their care delivery; however they may be required to seek exclusive permission from the infant’s parent or primary caregiver. In those instances where problems are detected, early treatments and counselling can alleviate many of the complications which might otherwise decrease the overall quality of life. For this reason alone, the right to withhold medical permission should never be exercised frivolously.

A similar rationale should be applied to the prescription of infant and childhood immunisation. The schedule of vaccinations recommended by health authorities offers a relatively safe and effective way to reduce the risk of contracting several childhood illnesses with potentially serious consequence. Because a small number of children may still acquire an illness, immunisation cannot be promoted as a means for ensuring full protection. There are also a number of minor side effects and some very rare cases of serious problems following vaccinations. When consulted by a concerned parent or caregiver, a good doctor or health nurse should be able to explain these issues with a degree of professional objectivity.

While the responsibility for ensuring infant health rests largely with primary caregivers, the importance of professional support from medical practitioners and community health specialists cannot be underestimated. For their own peace of mind, caregivers need to establish positive relationships with the professionals who deal in children’s health and wellbeing. This is not always as easy as it sounds. It is a fact that many doctors and associated health professionals are struggling with rising health costs, excessive workloads, and the bureaucratic inflexibility of regional health departments. A brief discussion with a medical intern will usually reverse the thinking of those who falsely identify medicine as a glamorous or privileged occupation. Given the undeniable challenges and constraints of their profession, the vast majority of certified health practitioners provide an excellent service which can be measured in terms of their expertise, efficiency, and dedication to client welfare.

Routine medical and developmental assessments are usually conducted by community health nurses, general medical practitioners, or allied health professionals specialising in childhood development. When complex problems or issues arise, infants can usually be referred to a consultant paediatric physician. The extended training and experience of these professionals provides a valuable resource for diagnosing and treating conditions which may lie beyond the expertise of general doctors, nurses, and other health workers.

In today’s economic climate, caregivers are often encouraged to pursue private health insurance as a means of funding the rising costs of private medical treatment. A standard private health policy will cover basic hospital, medical, and dental costs and may enable subscribers to select preferred physicians. It is also possible to obtain a comprehensive cover which includes additional benefits like access to a wider range of health specialists. This is likely to include initial assessment and subsequent treatments conducted by qualified dieticians, psychologists, physiotherapists, naturopaths, optometrists, and others. Understandably, the financial contributions required for a fully comprehensive level of medical insurance can be significant.     

One skill required by every caregiver, new or experienced, is the ability to maintain composure when dealing with acute childhood illness and injury. Despite widespread immunisation and careful hygiene, infants remain susceptible to numerous infectious ailments. These will often be transmitted through contact with other individuals, food, or contaminated objects. While most of the infectious illnesses cause temporary discomfort and can be effectively treated, it pays to be particularly vigilant during the first six months of life. This is the period when an infant’s immune response is developing rapidly yet remains considerably less efficient than those of older children.

Newborns also require adequate protection from physical injury and trauma. This involves a reasonable level of planning and preparation to ensure their surroundings are secure and clear of obvious danger. Particular attention must be directed toward vehicle safety and bedding, in addition to the potential hazards of  kitchens, bathrooms, outdoor environments, household pets, and other animals. One of the most difficult challenges in this area, at least for a few years, is the fact that what was safe yesterday is not necessarily so today. The natural intelligence of human infants continually motivates them to explore and interact with their surroundings in new and creative ways. While a constant checking and re-evaluation of physical surroundings can be exhausting, it is an important component of infant safety and wellbeing.

The main physical symptoms of acute illness in newborn infants include skin discolouration, localised or extensive rashes, swollen glands, elevated body temperature, convulsions, abnormal stools, or unusual discharge from the nose, eyes, or ears. All of these symptoms require medical assessment. Caregivers residing in both metropolitan and regional locations can telephone their child health advisory service for preliminary advice. When staffed by qualified personnel, these telephone services are an invaluable resource. They can offer helpful advice on comforting infants prior to medical assessment. In emergency situations they will often coordinate ambulances, or facilitate an immediate intervention as required.

While physical symptoms of an acute illness may on occasions need to be prioritised, competent medical professionals generally require some additional information to develop their evaluation and treatment. This relates to significant variations in behaviour or temperament during the onset of symptoms. For example, caregivers should attempt to accurately describe the amount or pitch of infant crying, sleeping and eating patterns, along with any noticeable shifts in attentiveness, responsiveness to sound and light, and general mood. Like most aspects of later development, the maintenance of health and wellbeing in newborn infants requires a considerable degree of composure and the ability to cooperate with health professionals. The medical knowledge and techniques applicable for infants are currently very sophisticated. For this reason alone, caregivers should not be overly concerned with this earliest period of childhood.  

In the decades immediately following the Second World War, many developed nations participated in a trend which saw formulated products supplementing or replacing the traditional source of infant nutrition. Today, reputable health authorities are strongly in favour of breastfeeding. For the majority of infants, breast milk represents an ideal source of nutrition during the first twenty-four months of development. In situations where breastfeeding is not an option, there are formulated products which provide the nutrients essential for normal development. With so many brands and varieties of infant formula currently available, parents and caregivers may become overwhelmed in their attempts to choose a suitable product. Undoubtedly, there must always be a strict emphasis on quality and safety.

There are three main categories of infant formula. The first of these includes all of the standard products which are based on cow’s milk. These are readily available, and appear to be suitable for most infants. Major companies which manufacture standard formula are often recognised for their research contribution into fundamental aspects of infant nutrition and development.

The second category encompasses those products based on soy proteins. Increasingly popular, soy based formulas were originally developed for infants with an intolerance to the lactose proteins in cow’s milk.

The third category of infant formula includes all of the products which are based on elemental protein compounds such as the short chain peptides and amino acids. These are usually prescribed by medical specialists for infants with specific dietary issues. Elemental protein formulas may be required for premature babies and infants with symptoms of chronic malabsorption, allergy, and other forms of food intolerance.

Pesticides pose greater risk for infants

There is evidence to indicate a significantly increased risk of pesticide exposure during important developmental phases of infancy and early childhood. Due to immaturity of their organ systems, infants are less efficient in detoxifying a range of chemicals and environmental pollutants. Early exposure to harmful agricultural chemicals is suspected to contribute to a number of health epidemics affecting children. These include neurological, cognitive, and behavioural problems, certain types of leukaemia, and disorders of immune functioning.

Choosing an infant formula

When choosing infant formula, as with any processed food item, it is important to consider the quality and safety of the primary ingredients. Most manufacturers of infant formula employ stringent controls to maintain the recommended standards for purity and consistency. All of the reputable brands have consumer help lines and websites which can be accessed for legitimate product enquiries. One concern repeatedly raised on these and other forums is the question of pesticide residue within milk and soy constituents. For the majority of products, the manufacturing standards minimise or eliminate the risk of detectable pesticide contamination.

Despite their apparent safety, many parents and caregivers are influenced by the negative incidents which are occasionally experienced in developing countries. In this context, selecting an organically certified product is perceived by many individuals as providing an additional level of protection against pesticide contamination. Those households prepared to prioritise organic products are unlikely to accept uncertified alternatives when it comes to infant formula.

When developed as a complete source of infant nutrition, standard formula is expected to contain the appropriate spectrum and concentration of essential nutrients. In view of this, parents and caregivers are frequently concerned with the apparent variation in quantity of certain nutrients. A good example relates to the elemental mineral, iron. Necessary for normal physical and cognitive development, adequate iron absorption is critical during infancy. Because certain types of iron have been associated with constipation and stomach pains in a small percentage of infants, several of the major companies have developed preparations containing a form of iron which is effective at lower concentrations. Occasionally marketed as low-iron products, these are intended to provide an overall level of iron which is approximately equivalent to a standard formula.

Another concern which has been raised recently is the inclusion of certain lipids believed to be beneficial for neurological and sensory function. Docosahexaenoic and Arachidonic Acid (DHA & AHA) have been included in several new products with subtle claims that these essential fatty acids will be advantageous for integral aspects of infant development. In truth, there is mixed evidence as to whether their inclusion makes any significant difference to a standard formula which already contains an appropriate balance of lipid compounds. Individuals seeking an objective evaluation on the listed ingredients of any formula product should consult a paediatric dietician.

Powdered formula is acceptable for most infants and can be purchased from pharmacies, supermarkets, and convenience stores. Each product will provide directions for preparing the concentrations and quantities required for infants within the relevant age categories. For safety and convenience, it is important to follow these carefully and avoid any temptation to use approximate measures. Incorrectly prepared formula may result in feeding difficulty and specific health problems like malnourishment, dehydration, and gastrointestinal inflammation.

For similar reasons, bottles and other feeding implements must be thoroughly washed and sterilised between feeds. With their simplicity and convenience, many individuals are now opting for the pre-prepared formula products. These tend to be expensive but reduce the likelihood of measurement error, wastage, and mess.