Chapter 6 – The Physiological Disorders of the Newborn

Every baby experiences some minor discomfort in the first months—nothing serious or harmful, but these can worry first-time parents. Here’s an overview of the most common ones:

• Cradle Cap: So named because it affects infants, though it has nothing to do with milk or breastfeeding. It is a form of seborrheic dermatitis that appears in the early weeks of life and resolves spontaneously within 6–8 months. The scalp, and sometimes the forehead, nose bridge, and groin folds, become covered in yellowish, greasy scales from sebaceous secretions. These are rarely bothersome and pose no risk to the baby’s health.
  The exact cause is unclear. One theory links it to maternal estrogen hormones passed to the fetus during pregnancy. There is no proven treatment, and forcibly removing the scales may irritate the skin. The best approach is to soften the area with almond oil and gently remove loose flakes with a soft brush after bathing.
• Gastroesophageal Reflux: Not a disorder, but a physiological phenomenon where stomach contents flow back into the esophagus during digestion. In infants, the valve between the stomach and esophagus (cardia) is often immature. Combined with a liquid diet and lying down often, this leads to spit-up or regurgitation.
  If the baby spits up frequently but is not distressed, the reflux is harmless and requires no treatment. However, stomach acids can irritate the esophagus, causing mild discomfort.
  Gastroesophageal reflux disease (GERD) is diagnosed if the reflux causes respiratory problems by entering the lungs. This is serious and requires treatment.
  If the baby shows signs of distress but continues to feed and grow well, guidelines suggest consulting a lactation consultant to observe breastfeeding technique and baby’s posture. If needed, a short-term treatment with alginates (safe thickening agents derived from algae) may help. These are given in drops after feedings and not absorbed by the body. They can be stopped periodically to check for spontaneous improvement. Most cases resolve with solid food introduction, usually within the first year.
  Formula-fed infants with GERD may benefit from: Switching formulas; Smaller, more frequent meals; Formulas thickened with rice starch or cornstarch.

• Colic: The most common and challenging issue in the first 3 months. The exact cause is unknown. Characterized by prolonged, inconsolable crying, typically in the late afternoon or evening. The standard definition of infant colic is crying that: Lasts at least 3 hours per day, Occurs 3 days a week, Persists for 3 consecutive weeks. Called “gassy colic” because the baby appears to have tense abdomen, clenched legs, and passes gas, though the air may result from crying rather than cause it. Other suspected causes include: Gastroesophageal reflux, Gut flora imbalance, Sensory overload, Immature nervous system, Circadian rhythm adjustment difficulties. Colic is distressing for parents, who may feel helpless. This stress can be sensed by the baby, worsening the situation. Thankfully, colic has no lasting health impact and usually resolves on its own by 3–5 months.
  Common remedies include: Simethicone, an over-the-counter anti-gas agent, Cimetropium bromide, an antispasmodic (prescription only), Probiotic supplements, which have shown more promise.
  To comfort a colicky baby: Lower sensory stimulation (light/sound), Gently rock or hold the baby, Place the baby belly-down and massage the tummy, Offer the breast for soothing, Sing lullabies or recite rhymes. La Even if these do not resolve the colic, gentle affection from parents always helps reduce the baby’s distress.
• Positional Plagiocephaly: A mild flattening of the back of the baby’s head (occiput) due to lying on the back. With the wide adoption of the back-sleeping position (recommended to prevent SIDS), positional plagiocephaly has increased significantly, affecting 37% of infants aged 8–12 weeks in Italy.
  This condition is benign, does not impact brain development, and usually resolves within a few months as the baby becomes more mobile and spends less time lying flat. Babies who start moving earlier often regain head shape more quickly.
  Helpful measures: Special pressure-distributing mattresses, Avoid pillows or soft accessories during sleep (due to suffocation risk), Postural exercises advised by pediatric physiotherapy experts (e.g., AIFI specialists), These exercises help speed up skull shape correction.