When baby goes from the womb to the world
Babies experience a rather drastic change in environment during birth.

From the small, dark, warm and fluid-filled space of the womb, they emerge into the large, bright, temperature-fluctuating and air-filled world.

They adjust to this vastly different environment through a remarkable series of physiological and hormone changes.

Key physiological changes include breathing, circulation and temperature regulation.

Hormonal changes after birth play a crucial role in these key changes.

However, hormonal effects and disruptions can occur as babies, while in the womb, are exposed to chemicals or hormones that are in the mother’s bloodstream.

Most of these conditions are temporary and resolve themselves after the first few months of life.

However, some might need initial treatment.

In this column, I will give an overview of a few common transient hormonal conditions in babies and maternal endocrine conditions that can affect babies.

Changes in baby

Common conditions involving hormonal changes in babies just after birth include:

> Blood glucose problems

Low blood glucose levels (hypoglycaemia) in newborns may occur because of an adjustment to post-natal life during the first two days of life.

Babies who are at risk are those who are born premature, large or small for their gestation, unwell at birth, or whose mothers had gestational diabetes.

Babies at risk should have their blood glucose levels monitored carefully.

In most cases, the blood glucose will stabilise after a few days.

Persistent low blood glucose levels warrant further evaluation before the baby is discharges from the hospital.

> Calcium disorders

Temporary calcium disorders in babies can occur due to various reasons.

Hypocalcaemia is when there is a low level of calcium in the blood.

It may result from being born small or premature, birth complications, insufficient vitamin D or calcium intake, or having a mother who had gestational diabetes.

Very low calcium levels can result in seizures.

Larger amounts of vitamin D and calcium supplements might be needed at first to treat hypocalcaemia.

It is also important to make sure mother’s vitamin D and calcium levels are normal.

> Baby acne

Baby acne is a common skin condition.

It usually appears as pimples on your baby’s face.

It is thought to possibly result from hormonal changes during the first few weeks, which overstimulates the oil glands in your baby’s skin.

Baby acne usually clears up on its own.

However, a doctor should be consulted if it becomes worse, is associated with other symptoms, or starts after the baby is six weeks old.

> Neonatal breast enlargement

Breast enlargement is common in babies – both boys and girls – during the early weeks of life.

During pregnancy, mothers pass on oestrogen and other hormones to their babies through the placenta.

After birth, the baby’s body needs time to break down these hormones.

As maternal oestrogen level falls, the pituitary gland in the baby’s brain releases prolactin, the hormone primarily responsible for milk production and enlargement of mammary glands in breast tissue.

As a result, some babies may experience breast enlargement, or even a milky discharge from their nipples.

This condition usually resolves after a few weeks.

Parents must not try to squeeze the breast tissue as it might result in a longer time to regress and predispose to infection (i.e. mastitis and abscess).

If the enlargement persists or worsens over time, it is always best to consult with a paediatrician.

Changes in mum

Endocrine conditions in the mother, such as diabetes, thyroid disorders or Cushing syndrome, can lead to imbalances in maternal hormone levels.

This, in turn, may impact their newborn’s growth, development and overall health.

> Gestational diabetes

If a mother has poorly controlled diabetes during pregnancy, her baby will be exposed to higher levels of glucose and insulin.

This can result in a baby being born larger for age, with a higher birth weight.

The higher levels of insulin circulating in the baby as a result of the high blood glucose also increases the risk of low blood sugar (hypoglycaemia) in the newborn after birth.

Hence, it is very important for mothers to have good control of their blood glucose during pregnancy.

> Thyroid disorder

If a mother has an imbalance of thyroid hormones, it will affect the baby’s thyroid hormones.

Thyroid hormones are essential for a baby’s metabolism and brain development.

Mothers who have thyroid problems must ensure their thyroid hormones are checked regularly during pregnancy and treated accordingly.

The baby’s thyroid hormones should also be monitored after birth to ensure they are normal.

> High cortisol levels

Cortisol, also known as a stress hormone, is produced by the adrenal glands that sit above our kidneys.

It plays a crucial role in the body’s response to stress, illnesses, energy levels and various other physiological processes.

Excessive cortisol levels in mothers, e.g. due to Cushing syndrome or medications, can cross the placenta and suppress the baby’s adrenal glands and stress response system.

In severe cases, it can result in a life-threatening condition known as an adrenal crisis.

> Medications and supplements

During pregnancy, it’s crucial to be cautious about the medications and supplements you take.

This is as some can potentially affect your baby’s hormones and organ development.

Always check with your doctor if the medication is safe to be taken during pregnancy.

This includes over-the-counter (OTC) medications for pain, cough and runny nose, as well as herbal supplements.

While some herbal supplements are generally considered safe to consume during pregnancy, others may have the potential to affect hormone levels or fetal development.

It’s important to research any herbal supplements thoroughly and consult with your doctor before taking them during pregnancy.

Keep an eye on it

Hormone-related conditions in babies are common and usually temporary.

Nevertheless, it’s important for parents to seek guidance from their paediatrician if they have concerns or if the symptoms persist or worsen.

Ensuring good maternal health and controlling mother’s endocrine conditions during pregnancy (and after) are also crucial to minimise complications to babies, and optimise their growth and development.

Dr Jeanne Wong Sze Lyn is a consultant paediatrician and paediatric endocrinologist. For more information, email starhealth@thestar.com.my. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
Children,Hormones and Kids,birth,child health,pregnancy,hormones
Babies undergo a big change in environment during birth, which requires physiological and hormonal adaptations to help them adjust.