The adjustment to the challenges of the newborn baby can be difficult for parents. Babies often develop difficulties with feeding, crying and settling, poor sleep patterns, vomiting and diarrhoea. Gastro-oesophageal reflux, milk allergy and lactose intolerance are often proposed as the underlying causes. Infants occasionally have difficulties with attachment and separation. An understanding of the specific underlying biological problems and psychological issues including interactions between babies and their parents can assist in the evaluation of many problems which present during infancy.
The incidence of food allergies, eczema, asthma and allergic rhinitis has increased in Australia over recent years.
Infants and young children can present with a range of symptoms which can be a manifestation of food allergies or reactions to inhaled agents. Eczema can be troublesome in infancy and young children. Careful evaluation of possible contributing factors eg infection and careful management with moisturising agents and the appropriate use of cortisone creams can be very helpful. Occasionally food allergies can contribute to difficult eczema in infancy and early childhood.
Episodes of coughing, wheezing and difficulty breathing are common in early childhood. In many cases this can be due to viral induced wheeze. In other situations, early onset asthma should be considered as a diagnosis.
An evaluation based on each individual case is advisable. Referral for allergy testing may be necessary.
Some infants and children have episodes of sudden unusual movements, collapse and possible loss of consciousness. If possible, video recording by the parents can be helpful in determining if the events are benign or possibly due to seizure activity or other causes which may need further evaluation.
Occasionally, EEG monitoring and brain imaging eg MRI are indicated to further evaluate such episodes.
Infants and young children can develop chronic constipation which does not respond to increased fibre in the diet. Careful evaluation for a specific underlying cause is often necessary. Some children require specific investigations and management may include long-term laxative therapy.