#15 What Every Parent Wants to Ask a Paediatrician About Babies

In this episode, I am joined by paediatrician Sarah for an informative conversation about some of the most common health concerns parents face during their baby's first years 🌿

Together, we discuss colic, digestive discomfort, skin rashes, fevers, introducing solids, baby-led weaning, food allergies, and how to recognise when a baby may need medical attention.

Sarah shares practical advice and evidence-based information to help parents better understand what is normal, what may require support, and how to feel more confident when caring for their little one 🤍

Whether you are navigating the newborn stage or preparing to introduce solids, this episode offers reassurance and guidance to support you along the way.

✨ Register for my free Birth & Baby Masterclass:

https://www.mymamadreams.com/birthandbabyantenatalworkshop

And if you would like to reach pout to Sarah, here is her Instagram @drsarahreich

Transcript

SPEAKER_02 0:00

Because every family deserves to feel informed and it's so important and confident and and for families like us, Sarah and I, that we have gone through through our our kids are now old and and so on. And we think if we had a p I think if I had a pediatrician when I need it and ask for help, don't wait, don't wait for things to resolve itself because sometimes with getting help from the beginning things mig uh become a lot easier. Welcome to my mama dreams. I'm Anna, a dule, gender sleep coach and lactation consultant based in Barcelona, empowering families worldwide through pregnancy, breastfeeding, and baby sleep. In this podcast, I'll work with you through the deep transformation of motherhood so you feel hurt support through the unknown and inspired to keep dreaming your own beautiful life. I created this space especially for families who feel a little bit far from home. I'm from Barcelona but lived in London for over 17 years where I had my babies. I understand what it feels to give birth and raise babies in another country, in another language, culture, and sometimes feel overwhelmed or alone. Here you will find gentle support, honest conversations, and practical guidance to help you feel calmer, more confident, and empowered, not only as a mother, but as a woman who continues to dream and growth. I'm so happy you're here. Let's begin. Hello, everybody, and welcome back to the podcast. Today I have a very special guest with me, Sarah. She's a pediatrician, trained and licensed in the United States, and now living here in Barcelona. Many of you know many of you know that my expertise focuses on pregnancy, birth, um, breastfeeding support, newborn care, and gentle sleep. But there are times when my parents ask questions that move into the medical side of things. Questions about feeding, about solids, questions about colic, rushes, fevers, digestive issues, and all of those things can leave parents wondering: is it normal? Should I be worried, or do I need to call a doctor? So today we're going to have a lovely conversation about some of the most common questions parents ask. Sara, welcome to the podcast. Thank you. It's so nice. Yeah, lovely. Would you like to tell us a little bit about yourself? What inspired you to become a pediatrician? And what uh brought you from the United States to Barcelona.

SPEAKER_00 2:44

Absolutely. Thank you. Yes, um, so I am my name is Sarah. I'm a board certified pediatrician from the United States. I've been practicing pediatrics for 18 years. That's what 18 years ago is when I finished my residency program. Um, I became a pediatrician just because I loved it. Uh, when you go to medical school and you try everything, I just loved pediatrics. I uh love the medicine of it, love babies, little kids, teenagers. It's a really amazing thing to watch a child grow and be part of helping them grow and helping their parents um uh navigate all that. Uh so on top of the medical piece, it's the uh family behavior, all the kind of development and growth, which I just really loved being a part of. Um, we came to Barcelona originally just for some uh adventure, and my uh my husband was able to work remotely. Um and initially I took a little time off, and then I started doing remote work too. And so now we just really like the lifestyle here. I have three children, um, two of whom are in university and one who's here with us in school. So we really love it.

SPEAKER_02 3:53

Lovely. Um, and in your experience as a pediatrician, what are some of the most common concerns that you have here from parents in you with all of your experience?

SPEAKER_00 4:04

Yeah.

unknown 4:05

Yeah.

SPEAKER_00 4:05

So I'll tell you, it really depends on the age of the child. Um, but with babies and newborns, it's pretty much sleep, sleep, sleep. Um, that's usually the number one, two and three question, um, because that is such a challenge in the early months. Babies are not supposed to sleep necessarily that long at a time, and that's a hard thing um to contend with as a parent. Of course, especially exactly.

SPEAKER_02 4:31

And tell us how many you've got 18 years of experience?

SPEAKER_00 4:36

18 years as a pediatrician. And I do, I've done um uh a range of primary care, urgent care. I have a specialty in obesity and in feeding practices of young children, um, as well as uh hospital work with infants, particularly. So I have a wide variety of experience with children, and now I do um some medicine back home and here in Barcelona I do some parent coaching of uh of locally, mostly uh a few clients of coach kind of coaching and behavior and um growth and development kind of thing. I'm uh working on my license, European license. So since I'm not yet licensed in Europe, plan to be, um I do more of a like parent coaching role here, but practice medicine back in the US.

SPEAKER_02 5:23

Okay, yeah, no, that sounds that sounds wonderful, and that's what most of my clients um like. You know, sometimes they ask me some questions and I say, good is too medical, you need to find a doctor. So here you are, you can give us that advertising expertise. So things like, for example, let's talk about colic. Oh, yeah. I hear this word all the time, and parents say my baby has colic because baby's crying a lot, maybe cries the whole evening, um, seems so uncomfortable. But what is actually colic? What do you know about it medically?

SPEAKER_00 5:59

So that's a great question. Um, the thing about colic is very interesting because no one really exactly knows what it is, it's been around forever, as long as there's been babies. People have been talking about this. There are a lot of theories. Um, some people feel though it's actually, um, and this is what I kind of subscribe to, really kind of just a variant of normal crying. So babies cry, and colic is extreme, and that this is kind of just the very high end of some babies really cry a lot. So colic has actually a very specific definition. A lot of parents are very scared of colic. They hear about it, they're worried, and they will say, You're absolutely right. I think my baby has colic, I'm afraid. But the definition of colic is inconsolable crying for great equal to or greater than three hours per day, equal to or greater than three days per week. So it's, you know, it's very normal for babies to cry. Babies are supposed to cry. That's the way they communicate when they have very immature nervous systems, when they're overwhelmed, when they're tired, they just cry. They can't talk, they can't do the things that we all do to relieve ourselves. So that is their uh their way of kind of dumping all of that feelings and usually it's fatigue, but sometimes they're overstimulated and they'll just kind of cry. So um, while crying in babies is normal, if it meets those criteria, we do call it colic. Um and it's uh the first thing about colic is to make sure that it is not any other cause of crying. So um when babies are crying for three plus hours and you cannot console them, so you try changing them, swaddling them, making sure they're fed, um, you know, rocking them and they just won't stop, or it's very, very difficult to get them to stop. You do want to talk to your pediatrician to make sure there's nothing else going on with the baby. And that can be a variety of things. Um sometimes babies will have uh, you know, they might be sick, uh, sometimes they have digestive issues, they have reflux, sometimes they can have um actually sometimes babies can get what's called a hair tourniquet, a piece of hair, like from their mom particularly, can get wrapped around like a finger or a toe and it can hurt. And again, this is the only way babies have to tell you that they're in pain. So um once you've seen discussed with your doctor, usually it would warrant one visit to make sure that the exam is normal and the baby's growing normally. And if that happens, then it's kind of just something that you have to um wait out. It usually starts around two weeks and the crying peaks around six weeks of age, and it's usually pretty much gone by four months of age. So it does go away, and it does not um for babies who have colic, it does not indicate a future of a difficult or um a child who's gonna have any problems. It actually doesn't. The studies show kids who have colic end up being just kind of in the normal range of any other child.

SPEAKER_02 9:06

Yeah, and I think, and that's I think what's very important to remark the fact that you say that the description of colic is three hours of uncomfort, like they can't comfort the baby for three hours, um, three times a week, uh three days um a week. But the thing is you said that they can't comfort the baby, and a lot of the things when I come to a place to see a parent and they say, Oh, the baby's crying, I don't know what to do, it's crying so much, and I say, put your baby on the breast, and the baby stops crying immediately. I said, This is not uncomfortable crying, the baby has stopped crying. So if you can manage to get the baby to stop crying, that means baby's not in pain, baby wanted comfort, baby was hungry, baby's tired. So if you do all of the things like breastfeeding or bottom feet, um shoot them, rock them, help them to fall asleep, and none of this helps, then if that happens during three consecutive hours, then we're talking about colic. The rest is normal baby's behavior. And and I think and and what happens a lot of the times parents go to a doctor and they go to the doctor and they ask, this is what's happening, and a lot of the times doctors they just say colic. Oh, it's colic, it's colic, because they might have miss that the client, the the parents they might have miss saying, um, yeah, well, if I offer the bread, my baby stops crying. And then the doctor would be able to see that. But a lot of the times I think it's misdiagnosed, and it's everything goes in the bucket of colic.

SPEAKER_00 10:46

I couldn't agree more. And I think one of the things I say to my patients over and over again is that babies cry, and it is so normal. So once, especially if you have ruled out that, you know, I always say take their temperature. You you do want to make sure that they're fed, that they're changed, they don't have a fever, nothing's wrong. And if but if nothing's wrong, babies cry and um and they need soothing. Uh, I think that it's also important for parents to understand one of the things that's so hard is that is such a difficult noise that the hearing or a baby cry, it emotionally is difficult and it's frustrating and it's hard, and you get worried and scared. So I always say it is important for parents to take care of themselves. And if the baby's just really not calming for a minute and you feel overwhelmed, it's never wrong to put them in their bassinet in a safe place and just let them cry for a few minutes and get yourself, you know, uh a moment to rest and calm down because the baby will be fine, and even maybe the baby will fall asleep, and then you can just let it be for a little while.

SPEAKER_02 11:52

Yeah, sometimes it's that the baby wants to sleep and you don't know how to, or you're just too anxious, and then the baby can sense that you are anxious and it gets even more anxious. Yes, and the thing is we hear we're not judging anyone, we know it's very difficult to be 24 hours soothing a baby, and it's super normal not to have the ability, the time, the energy to be soothing the baby, but just taking the label of colic for everything. I'm just um yeah. So, what I wanted to be clear is that it's normal the babies cry and you don't need to have your baby content all the time. It's it's okay. It's okay sometimes. Absolutely to just yeah, not be able to control your baby for a bit. That's it.

SPEAKER_00 12:36

It is one thing I'll add is one of the things that sometimes happens, particularly with new parents who have a baby, even who doesn't have colic but can be a little on the side of fussy crying, is the parents will start to kind of solve the problem of the baby and they'll chase down, oh, I think it's this and I think it's this. And this is when, like, as we've discussed, you know, already just cry sometimes. And sometimes I think because what happens is when parents are starting to do that, then their anxiety ratches up and increases, and then it it becomes a little bit of a cycle because the baby can kind of sense that. Um, so it is really important. Again, you want to make sure there's nothing going on that the baby doesn't have a fever, they don't have reflux, but babies do cry and and like, you know, remaining calm inside. And maybe I I I will say to parents sometimes it might be a mystery. You might never know why that day they cried for two hours. And you know, but if you can soothe them and calm them down, um, you know, it's very, it's it's uh that's just a normal part of being a baby. It's important to remember that zero to six months is the greatest uh most rapid period of growth in the human lifespan. So if you think about um how often kids get things like growing pains in their legs, um, you know, even teenagers get those. Uh so you know, it might the babies are very their body is just growing and changing and so quickly. So quickly. And um, for instance, when they're going through a gross birth, one thing that happens is their uh body will the I mean the body the human body is an amazing divine thing. And the babies will get more hungry as they should to take in the calories to prepare for the gross burt. But sometimes um because their stomachs are so small, then in those days or weeks when they're um increasing their caloric intake, the amount of breast milk or formula that they're taking, uh, their belly is a little upset because they're just eating more than they were. So if I gave you a big meal every day, you might think, oh, my stomach hurts a little bit.

SPEAKER_02 14:41

Exactly.

SPEAKER_00 14:42

So even though it's a natural process, which it truly is, they may feel a little uncomfortable in their belly and might need a little extra soothing from mom and dad. And that that is hard, or parents, um, whoever, who all their caretakers. Um, and this is where I also do advocate if you have family, friends, your partner, uh, grandparents, cousins, whoever, um, if you can do it, even find a trusted sitter, you parent, you know, whoever's taking care of the caretakers of the baby do need a break, um, even if it's an hour, you know, just to relax, take a time.

SPEAKER_02 15:20

Totally, totally. And talking about baby digestion and um gut health. So many parents worry about gas, trap, and digestive discomfort. So, how much of this is normal and when we should seek medical advice?

SPEAKER_00 15:36

So it's incredibly normal. Um, babies, uh, I guess we're on a podcast, so you can't see this, but I'm making um my first and thumb finger a uh a small circle, and that's how big their stomachs are when they're born.

SPEAKER_02 15:49

Like um a walnut.

SPEAKER_00 15:53

Oh no, even a smaller walnut, like so um it's very normal for babies to have uh digestive issues. You also have to remember that their gut bacteria does not get populated till after they're born. So they don't take anything by gut in utero in utero when you're pregnant. So all of that process is happening. It's incredibly complicated and complex. Their gut is being populated with the good, healthy gut bacteria. They get gas. When they cry, they take in air, um, they have these very small stomachs, um, they suck to soothe. So sometimes um they will maybe take a little more uh food in than they um need, although babies are really beautiful at um alternate, as you know, as a lactation consultant, at non-nutritive and nutritive sucking. So, you know, feeding when they want food and and then just you know soothing themselves.

SPEAKER_02 16:48

But sometimes some if the if the mom has a very, very um strong let down, the the meal might come um without the baby wanting it, and then they get uncomfortable.

SPEAKER_00 16:59

Exactly. So it's very, very common for babies to have this. And in fact, it's very interesting because if you do x-rays of babies, um, which these are studies they did a very long time ago, we would never do them now. Many babies will have a lot of gas in their belly, and some of them find it uncomfortable, and some of them don't. So parents get very, very worried. It's very normal. And there's a lot of things you can do. You can put them down and bicycle their legs, make their legs go around. You can do um baby massage techniques, um, carrying them on, like putting a little light pressure on their belly. So um when you put, you know, carrying them on like on their belly, putting them on their belly on your arm to relieve that pressure, make you know, burping them, those are the things that can help relieve that. Um, but it's very normal. Every baby has it at some point. Um, you should worry. Certainly, um, one of the most important and signs that we can see in a baby is how is the baby growing? If your baby is consistently growing well and making a good number of wet diapers every day and having a normal stooling pattern, which for babies really is their own stooling pattern because babies, different babies have different stooling patterns, you can be assured that everything is probably fine. And this is just normal discomfort. If babies are arching their backs, crying around when they're eating, having a lot of vomit uh spitting up and projectile vomiting. Um, if they're not growing well, they may have reflux, and that might be a cause to go to your doctor and just discuss with them do they need treatment for reflux? And there's a variety of home remedies you can do for reflux.

SPEAKER_02 18:39

Um, but the uh sorry to stop you here. You said when they arch in their backs and crying when they're eating, because if they are arching the backs when they're not eating, they have eaten a while back or before they eat, that could be for me a sign of tyness. Because when they cry, they really arch their backs, and then a lot of the parents I think they're in pain because they arch in their backs and they get in very upset, but that could be a lack of sleep rather than food. So one of the things to differentiate that is to see when they do these um these movements while they are eating, right?

SPEAKER_00 19:17

Yes, absolutely. And I will tell you that not all arching back does mean reflux. So um it's just uh and it usually is you're absolutely right, and thank you for bringing up that point. It's around the eating, so really it's kind of right after they've eaten, usually they'll do that movement.

SPEAKER_02 19:33

Um they they they have the reflux because they have the acidity in their throat, right? So yeah, or they need to burp. Yeah, okay, and how about the um one of the other things, biggest questions that worry many parents is um, especially first-time parents, um, about uh the fever. Yeah, what actually is fever and when do we need to look seek for medical advice?

SPEAKER_00 19:57

Absolutely. So fever in an infant is anything uh 38 degrees Celsius or above is considered a fever. Below that is not considered a fever. Um, it does not mean that you shouldn't call your doctor if your baby is acting sick, uh, but that is a fever. So any baby under two months that has a fever of 38 C or higher needs to be taken immediately to be seen to an urgent care center or um a hospital or your doctor, if your doctor is open in the day and you discover the fever, you can take them there. Um once the baby is uh between two and three months, you uh you don't have to take them in immediately, but you should call a doctor immediately. So if you're having two and a half month old and uh you find they have a fever, I will call your doctor right away. Over three months, um, you can treat them uh at home a little bit and um then kind of see how they're doing. That then over three months it starts to depend on how the baby looks. Does the baby look ill? Is the baby feeding? Is the baby consolable? Um and but it's still maybe worth a call to your pediatrician just for self-reassurance. Fever is a very, there's a lot of um feverphobia, we call it in parents. Um, once the baby, though, is over six months old, I actually tell parents to not take their temperature generally. Um, it's good to have a thermometer in case they seem very ill. But you know, then after six months, I like to say, how does the baby look? You know, if you have a nine-month-old baby and they seem to have a little fever, they seem a little warm, but they're drinking, they're taking their breast milk or their formula, they're eating a little solids, maybe a little less than normal. They're very consolable, they seem a little tired, but they're sleeping, waking up, interacting, smiling with you, doesn't really, they're fine. They they might have a viral illness. And um, but if they see if the and even um what one of the one of my mentors uh taught me this, and I always say to parents, once again, this is after six. Months and certainly after a year, particularly. Um, between six months and a year, I do still like to maybe hear from a parent after a day or two of fever. Um, but I always want to say, especially after a year old, I really care how the baby looks, not how high the fever is. I have seen uh, you know, if a child even has a very high fever, um, you know, 40, but they're drinking, they're consolable, maybe they're playing quietly, they eat a little food, maybe not as much as normal, they're not vomiting, they're not having any trouble breathing, maybe they have a runny nose. They're just that's their their body actually, the fever is the way your body fights the entire fever.

SPEAKER_02 22:38

Exactly. It's not something I that's something I'm not worried about, fever, because my my oldest kid, he has papa. Um, so he gets recurring fevers, he doesn't get them that much anymore, but he used to get them from a very few months old. And he would get fevers up to 41 um degrees, you know, like super, super, super high fevers. And I've gone through such high fever that he would be shaking, and so that now if he's sometimes he has a little bit of fever and I don't even take the temperature, as you said, because I can tell, I can I can tell the symptoms as soon as the fever goes high, he falls asleep, for example. If he falls asleep on the sofa, he has a fever. Yes, otherwise he would never fall asleep. Um, or if he says, you know, when he gets very cuddly and and very mommy, it's like he's not well. Or if he rejects a biscuit or ice cream, I know he's not well. That's a good sign. Totally. Like each mom knows when their babies are not getting um, or the little ones they're not well.

SPEAKER_00 23:43

One thing I will just add is I always say to parents, um, and again, uh, you know, if they're under even three months old, you absolutely need to be contacting or taking them to seek medical care. But I also think it is actually never wrong to give a call to your doctor, because if you're scared and you want reassurance or something just doesn't feel right to you, it's okay to give a call. Um, but especially like I said, in a baby, um, you know, when they're still under six months or even under a year, certainly if they have a new rash, or they seem very ill, if they're not eating or drinking, if they're vomiting, if they have neck stiffness, or just seem very drowsy and hard to wake, all of those are reasons to actually just take them in.

SPEAKER_02 24:25

Well, this is the question you have to, yeah, definitely. When they have that little, yeah, yeah. Yeah, yeah, that's super important.

SPEAKER_00 24:33

But I couldn't agree with you more. And like I said, once the kid is over one, once the children are over one, I often tell parents, just don't even measure it unless they seem very ill. Just look at how the baby looks. And if your child looks okay, they might just need a hug and a little extra, you know, um breast milk or formula or a little water or just some cuddles and some sleep, and they'll be uh usually be fine quickly.

SPEAKER_02 24:59

And it and it also depends on the culture where you are, because um, I remember in the UK when I lived in London, I would take my kids very quickly to the doctor as soon as they had fever. But I'm talking about past the one-year-old, because when they new boards, of course, you need to go straight away if they have a fever, but past the one-year-old, uh, the doctor would tell me off for coming soon to the to see them, and they would say, It's normal, kids have viruses, you don't need to come. If your kid has had a fever for more than three days, then come see us, or more than two, three days. But otherwise, it's just a normal virus and don't worry about it. And here in Catalonia is the other way around. If you don't take them, the doctors they say, Why didn't you take him earlier? And and you feel a bit judged by other parents as well, because they do um go to a doctor very early. Um, it's kind of recommended to go much earlier. I think we've got more um we've got petricians as well. Yeah. Yeah, which in other countries they don't like, uh they don't have it as a general care. Like here, when you have a baby, the first thing you get referred to pediatrician, and your baby will be always looked by a pediatrician, which I think it's amazing because um we had my baby, my my oldest child, he wasn't diagnosed with his FAPA condition until he was two and a half years old.

SPEAKER_00 26:19

Oh my goodness.

SPEAKER_02 26:20

Yeah, because in the UK they kept giving him antibiotics um every month, and and because they we were not seeing a pediatrician, we're seeing GPs, and GPs they didn't know. And when I saw pediatrician here, and I said, Are you not gonna give antibiotics to my baby? And and she says, No, we never give it's very rare that we give antibiotics. And I said, Well, they give them to me every month in the UK, and she's like, Okay, we need to look into that. So I think if you are in another country as well, um if because I didn't know when I was there, um, how important it is to go see a physician, go get a private pediatrician because GPs are not aware of these rare conditions, and it's so important. But anyway, Sarah, I love talking to you, but um I think we're going a little over the time I wanted to have this podcast. Um so there is so many information out there these days, and sometimes too much information. And having guidance with a qualified pediatrician can really help families and make us feel calmer and more confident.

SPEAKER_00 27:28

Absolutely. And that's one of the reasons we exist as pediatricians. Um, as we say, children are not just little adults. I do agree with you. Um, we understand the particular diseases and illnesses of children um and babies uh and how to treat it. So um, you know, I'm uh I'm a real advocate for seeing a pediatrician, especially if something just doesn't feel right as a parent.

SPEAKER_02 27:52

Yeah, exactly. So thank you so much. And if you're if you're listening today and you are preparing for your baby's arrival, or you're navigating newborn life, feeling challenges, sleep difficulties, or simply feeling overwhelmed by all the information out there, remember that you don't have to figure it all out alone. If you would like support um with your baby sleep routines, breastfeeding, new care, um, anything related to baby, you can just um book a free consultation call on my website at www.mymamadreams.com. Um, and you can we can look at what's happening with your family and what feels right for you. And if your questions are more focused on medical concerns, nutrition, uh introduction to solids, which we don't have time to talk about, but we will record another episode, Sarah.

SPEAKER_01 28:46

Absolutely.

SPEAKER_02 28:47

Um, feeling difficulties, digestive issues, allergies, growth, development, anything that you would benefit from a pediatrician's perspective, Sarah would be very happy to come and help too. So I will include her contact on the details of the podcast in the description. So you can reach out, yeah, you can reach out persons um whenever you can reach out to her whenever it's with you, and she'll be very happy to help you. Because every family deserves to feel informed, and it's so important and confident. And and for families like us, Sarah and I, that we have gone through through our our kids are now old and and so on. And we think if we had a I think if I had a pediatrician where I need it, and ask for help, don't wait, don't wait for things to resolve itself because sometimes with getting help from the beginning, things might uh become a lot easier.

SPEAKER_00 29:42

Absolutely, absolutely, thank you so much. I appreciate it.

SPEAKER_02 29:45

Pleasure, Sarah. Thank you so much for listening. A huge thank you to Sarah for sharing the knowledge and expertise with us today. And if you enjoy this episode, please share it with another parent who might need um help as well. And and always be gentle with yourself. Parenthood isn't about getting everything perfect, it's about learning, growing, and finding the support you need along the way. So have a beautiful week, and I will see you in the next episode.