Lumps and bumps, bits and bobs
DISCLAIMER: The following advice is of a general nature only. Information from online sources, including this one and the sites I link to, should always be confirmed by a medical doctor. There is not one remedy that suits everyone; advice has to be individualised.
BELLY BUTTONS
You need to know…
They rarely give trouble
They do need to be cleaned (water is fine)
They should be allowed to dry
The dry stump will fall off, usually by 2 weeks at the latest
May get a little moist and smelly
A granuloma may form = pink/red lump
Should be checked if it keeps weeping and/or the surrounding skin is red, hot, swollen and/or baby is unwell
More information
Umbilical hernias
Can be quite large
Are caused by material (usually fat) pushing through the weak spot in the muscles where the umbilical cord was attached
Rarely cause trouble
Will be larger when baby is crying, coughing or straining to do a poo
Can be pushed back in, but can pop straight back out!
Usually go all by themselves by 2 - 5 years of age
If still present by age 5, they can be fixed with an operation
More information
INGUINAL HERNIAS
Important information
the lump is in the groin
more common in boys than girls (8 boys to every girl)
more common on the right than on the left, can be on both sides and in boys, may extend to involve the scrotum
do need to be fixed with an operation as they may contain bowel rather than fat and this can get trapped or twist on itself and die (strangulate = dangerous)
the younger the child, the sooner the operation should be done
will be larger when baby is crying, coughing or straining to do a poo
can be pushed back in, but can pop straight back out
more information
COMMON ISSUES UNDER THE NAPPY
GIRLS
Discharge or blood
sometimes there will be some white coloured discharge or even a little blood coming from the vagina in the 2-10 days after birth
this is a normal response to mum’s hormones
this will stop in a few days, you don’t need to do anything
Vaginal skin tags
you might see an extra bit of pink skin (like a small tag) around the opening to the vagina in a newborn
they are normal, cause no problem and go by themselves, usually in 2-4 weeks
this is a common condition where the skin either side of the vagina sticks to itself
it usually presents while baby is still in nappies and is most common between 1-2 years of age
we don’t know exactly what causes it, but sometimes it comes after an irritation or infection
it doesn’t cause pain and it almost always separates by itself, before puberty
occasionally it causes some issues with doing a wee as the wee can go out at an odd angle due to the fusion
rarely it increases the risk of a urine infection
you don’t need to do anything. It will go by itself
gentle massage or oestrogen cream can be used if it is still present as puberty approaches or if urination is affected or urine infections are occurring
BOYS
the testicles (“balls”) are checked regularly to see if they are sitting in the scrotum (sac)
in about 3-4% of newborns, one or both of the testicles may not be sitting down where they should be
most (75%) undescended testicles will sort themselves out by the age of 3 months
if they don’t sort themselves out by 6 months of age, surgery will be required
in these cases, the testicles will be able to be found and “milked” (gently pulled down) into the scrotum
usually do not require an operation
should be followed up until the position of the testis is certain
a hydrocele is a collection of fluid around the testicle, making the scrotum look swollen or large
may occur on one or both sides
transilluminates = if you put a torch behind the testicle, you will see the shadow of the testicle but the rest of the scrotum lights up
you can’t squeeze the fluid away
usually go by themselves
if still present at 15-18 months of age, surgery may be required
HIPS
Hips are really important
Developmental dysplasia of the hips (DDH) may cause serious long term problems if not found and treated early
DDH is more common in girls than boys (4 girls to every boy)
Not very common = 1:1000
Is NOT the same as unequal skin folds (1:4 children)
Your midwife, doctor or early childhood nurse will check the hips at birth, 6 weeks and 6 months
We can test with an ultrasound scan up to the age of 4-6 months, in older children we use an X-ray High risk hips: If baby falls into any of these categories, an ultrasound scan is recommended even if the examination is normal: Breech position, low liquor volume or DDH in a parent, brother or sister
FEET (the simple stuff)
Taping toes
CURLY OR UNDERLAPPING TOES
Some children have toes that curl downwards, usually present at birth and this is no problem at all until perhaps when they are walking
Most curly toes will straighten up without anything other than time
If they stay curled, shoes that fit well are really important and inserts which help to cushion the toes may be helpful
More information
OVERLAPPING TOES
Most commonly involves the little toe
Can run in families
Can go with time (25%) but can be helped (94%) with taping for 3 months
If not sorted out, it creates trouble with footwear, with rubbing causing corns and calluses
Every now and then, surgery is needed to straighten the curly or overlapping toes, but this is usually not until the child is 5 years or older
FLAT FEET
Flat feet are entirely normal in children
Babies have fat, flat feet but nearly all of them have flexible feet and this causes no trouble
As they get older, the arch develops (usually by age 6-10) in most (80%)
The best thing to help the feet develop normally? Time. And shoes that fit well, when needed. Bare feet are fine!
Inserts (orthotics) or special shoes are not necessary unless the foot is rigid/there are other issues/pain
Most adults who have flat feet have no issues with their feet
If it’s not causing trouble, it doesn’t need fixing
If you want to look for the arch, it is often best seen when standing on tiptoes
General information on foot care in children is here, information on flat feet is here and here
Wet feet and dry cement
Show the difference between normal children (age 3 and 1) and an adult
Positional talipes
Will be identified after birth
The foot/feet points down and in, but can be stretched back to normal
Will almost always go by itself
Stretching exercises may be recommended
More information
CLUB FEET
This will be identified on a routine scan or at birth
The foot/feet points down and in, but can’t be stretched back to normal
You will be under the care of a specialised team
More information
EARS
Preauricular sinuses
Also known as preauricular pits
Are common (1%)
Occur on both sides in 25% of cases
Are as likely to occur in boys as in girls
Are present from birth
Rarely give trouble
Sometimes are associated with infections
Rarely require surgical treatment
Ear tags
Are common (0.5-1%)
Are as likely to occur in boys as in girls
Are present from birth
By themselves, they don’t give any trouble
Are usually best left alone
Can be surgically removed (rarely needed)