Babies A to Z


Babies often make repetitive sounds from six months of age. By 8 to 9 months the child will recognise its own name, and at about the same age s/he will say “mama” and know what it means. By twelve months the child will be able to name a few objects and people, although they may not necessarily use the correct name. By 18 months of age a child will have a vocabulary of about 20 words, but some children with normal intelligence do not speak coherently until much older. By the time they are two years old, most children can make a short sentence of three or four words.



Two sets of teeth grow in a lifetime. The baby, or primary, teeth start to appear a few months after birth (although they have begun forming while the baby is still in the womb) and will usually have reached their full complement of 20 by about two and a half years of age with ten on the top and ten on the bottom jaw. The front cutting teeth are the incisors, and the back grinding teeth are the molars. Dividing these are sharp pointed eye teeth or canines.

At the age of about six, a child develops the permanent six-year-old molars. Some time after this, the roots of the baby teeth begin gradually to dissolve and the teeth fall out, in order to be replaced by the permanent teeth. This process will usually be completed during the teens, with individual children varying a great deal. The permanent teeth have started forming in the gum from the age of about two. Care and hygiene of baby teeth are no less important because the teeth will eventually be lost. Decay and infection can spread to the developing teeth and the baby teeth are important in guiding the permanent teeth as they grow out through the jaw.

Permanent teeth are larger than baby teeth and total 32. They are accommodated by the increased size of the older child's jawbone. Starting from the front there are two incisors, one canine tooth, two premolars and three molars (the one furthest back is the wisdom tooth). This pattern is repeated on both sides, and in the top and bottom jaws.

Sometimes the jaw isn't large enough for the wisdom teeth, which may not appear until the late teens or early twenties. In this case, they may remain embedded in the jaw, and if this causes problems they may have to be removed by dental surgery. However, some people never grow their wisdom teeth and never develop any problems.

The part of the tooth that can see is the crown and is covered with shiny white enamel - the hardest substance in the human body. The lower part of the tooth that fits into a socket in the jaw is the root, and this is covered by a bony material called cementum. The area where the root and crown meet is called the neck. The root is attached to the jaw by a membrane. The bulk of the tooth consists of a bone-like substance called dentine. In the centre of each tooth is the pulp, which contains the living matter such as nerves, blood vessels and connective tissue. This is the part that hurts if the tooth becomes infected or damaged. A fine canal (the root canal) runs from the pulp down either side of the root, and joins up with the body's main nerve and circulation systems.

The jawbone in which the teeth sit is covered by the gum, technically known as the gingiva, which is attached to the tooth enamel around the neck of the tooth. The sockets in the jaw in which the teeth sit correspond in shape to the teeth although they are slightly larger. The upper and lower teeth themselves are designed to fit perfectly one into the other when the jaw is closed, a feature that gives maximum chewing efficiency.

The lower jaw (mandible) is joined to the base of the skull by the temporomandibular or jaw joints.



Most babies have some discomfort while they are teething. They may dribble and become fretful and irritable. Sometimes bowel movements become slightly loose, but it is a mistake to blame diarrhoea, vomiting, fever or any other sign of illness on teething, although teething may lower resistance so that the child is more susceptible to viral infections.

The reason a child cries when teething is that its gums are hurting. Chewing on a rattle or teething ring may help, as may rubbing the gums with a finger. If necessary, gels that contain a mild pain reliever and a gum soother can be rubbed on the gums. These are available without a prescription from chemists.

Teeth normally start to appear around five or six months, although babies vary widely, with some cutting a tooth as early as three months (some children have even been born with teeth eg: Napoleon Bonaparte) and some not until seven or eight months. A baby who cuts teeth earlier than average is not brighter or more advanced than one who cuts them later.

Teeth usually appear quite rapidly in the child's second six months, and by the time they are nine or ten months, most babies have both the top and bottom four front teeth. The molars then start to appear around the age of one. These are likely to cause some discomfort even in a baby who has had none before, since the larger, broader shape makes it difficult for them to push through the gum. Most of the first or “milk” teeth will have arrived by the age of two and a half. Chewing on a teething ring, rubbing the gums with gels that contain a mild pain reliever, and paracetamol drops or elixir, will ease any discomfort. Infants are more susceptible to infections while stressed by teething.

The baby teeth will start to loosen and fall out when the child is about five, and the permanent teeth will then begin to erupt. It is a complete mistake to assume that because a child will lose their first teeth therefore dental care is of reduced importance. The second teeth are already in the gums and a child whose first teeth are allowed to decay faces a lifetime of dental problems.



A person’s temperature is measured using a thermometer. Thermometers may be a glass tube filled with mercury (silver colour) or alcohol (dyed red), a heat sensitive electronic probe, or an infrared measuring device which is gently placed in the ear canal to instantly measure the body’s temperature.

The most common method of measuring the body temperature is to place the thermometer bulb under the tongue, and leave it there for at least two minutes. The thermometer may also be placed in the anus, and this is very useful in children who might bite a glass thermometer. The third method is to place the instrument in the armpit, but this gives a reading about half a degree centigrade lower than the correct one.

The heat sensitive strips that can be placed on the forehead, give only a very rough guide to the patient’s true internal temperature.

See also FEVER


Most children will scream and cry with rage if they are frustrated. Nearly all children have the occasional tantrum, and some children have them frequently.

Tantrums seem to reach their peak around the age of two when the child is beginning to assert its own independence - hence the “terrible twos”. Toddlers who have a lot of tantrums are usually lively children, and may be very intelligent and have a strong desire to extend their horizons to things that are still beyond them. It is important to be aware that a child who has a tantrum is a child whose frustration has gone beyond the limits of their tolerance and the child can no longer help their behaviour.

A tantrum is as frightening for a child as it is unpleasant for you. The best way to deal with tantrums is to prevent them by organising the child's life so that frustration is at a minimum. If a child is having a tantrum, it is pointless to try to remonstrate or argue - the child is not capable of any rational response. Try to prevent the child from getting hurt or causing damage by holding them gently but firmly on the floor. As the child calms down, they will usually find comfort in your being there.

A child should neither be rewarded nor punished for a tantrum. If the tantrum was because you wouldn't let them go out to play, don't change your mind once the tantrum has taken place. On the other hand, if you were about to go for a drive in the car, continue with your plans once the tantrum has ended. As the child gets bigger, stronger and feels more confident in its ability to cope with life, the tantrums will usually come to an end.

One of the most frightening forms of tantrum (for parents) is the young baby who holds its breath, possibly until it turns blue and even loses consciousness for a brief period. Older children sometimes bang their heads on the ground or the sides of their cot. Despite their obvious unpleasantness for parents, these forms of behaviour do not seem to cause any harm, although a parent worried about some serious abnormality shouldn't hesitate to consult a doctor.



Tetanus (lockjaw) is a very serious worldwide disease that attacks muscles. The bacterium Clostridium tetani, which lives harmlessly in the gut of many animals, particularly horses, is responsible. When it passes out in faeces it forms a hard microscopic cyst, which contaminates soil. It can remain inactive for many years until it enters a cut or wound where it starts multiplying and produces a chemical (toxin), which spreads throughout the body in the blood. Deep wounds, such as treading on a nail, are particularly susceptible to a tetanus infection.

The toxin attacks the small muscles used for chewing making it difficult to open the mouth (thus the common name of lockjaw). Larger and larger muscles are then attacked, irritating them and causing severe spasm. Excruciating pain from widespread muscle spasms may be triggered by the slightest noise. The patient remains conscious, but eventually the muscles that control breathing and the heart are affected.

There is no effective treatment other than muscle relaxants and mechanical ventilation. Although the bacteria may be killed by antibiotics, the toxin remains in the body. Death occurs in about 50% of patients, even in good hospitals.

A vaccine (tetanus toxoid) is available, but it does not give lifelong protection, and revaccination is necessary every ten years until age 50, or after five years with a deep wound.



In a young baby, sucking is a very strong reflex, and most babies suck their thumbs or fingers at some stage. Most will stop on their own after a few months, or perhaps after they begin toddling around and have more interesting activities to occupy them. Some parents feel they should stop a baby sucking, but this is likely to do more harm than good, as the baby's sucking reflex remains unsatisfied. If necessary, a dummy may be substituted for the thumb.

If a toddler of two or three is still sucking its thumb, a parent may wish to remove the thumb gently and distract the child with another activity, but to get cross or force the issue will frustrate and upset the child and usually be unsuccessful.

See also DUMMY


Tinea is a term used to describe any fungal infection of the skin, hair or nails. The technical term is dermatomycosis. Ringworm is a lay term that may be used for a fungal infection involving skin only.



Tinea capitis is a fungal infection of the skin on the scalp that usually occurs in children. The fungi usually come from the Trichophyton, Microsporum and Epidermophyton families. It is caught by close contact with another infected human or animal (eg. cat, dog).

The child develops an irregular, relatively bald patch on the scalp covered in a fine scale and broken hair stubble (the fungi invades the hairs and causes them to become fragile and break). A severely affected patch may develop a thick build-up of scale and form a fungal abscess (kerion).

The diagnosis can be proved by taking a skin scraping or hair sample, and examining it under a microscope for fungal spores. Ultraviolet light (Wood’s light) in an otherwise dark room will cause a bright green fluorescence of hair and skin affected by a fungus.

Antifungal ointments, lotions, tinctures and shampoos are all very effective treatments.



Tinea corporis (ringworm) is a fungal infection of the skin that is not caused by a worm. The fungi usually come from the Trichophyton, Microsporum and Epidermophyton families, and are caught by close contact with another infected human or animal (eg. cat, dog). The fungi prefer areas of the body where there is heat (under clothing, in shoes), friction (from tight clothes or skin folds rubbing together) and moisture (from sweat), and more common in the tropics. It affects both sexes and all ages equally.

The fungus settles in one spot on the skin, where a red dot may be seen. This slowly enlarges as the fungus spreads, and after a few days the centre of the red patch becomes pale again and similar to normal skin, because the infection is no longer active at this point. The infection continues to spread and forms an enlarging red ring on the skin. Multiple ring-shaped spots with a pale centre are seen on the chest, abdomen and back. It usually does not cause an itch or discomfort. The diagnosis is proved by taking a skin scraping and examining it under a microscope for fungal spores.

Antifungal creams, ointments, lotions and tinctures are usually effective. Antifungal tablets are available for more serious infections, but sometimes they are very slow to work, and may need to be taken for up to six months. Without treatment, the ringworm may persist for many months.

The prognosis is very good with proper treatment, but the infection tends to recur if treatment ceased prematurely. Children may return to school a day after appropriate treatment has been commenced.



Tinea cruris (“crotch rot”) is a fungal infection of the skin in the groin.

The fungi usually come from the Trichophyton, Microsporum and Epidermophyton families and are caught by close contact (eg. sexual) with an infected person, or in babies may be due to wet nappies or sweaty skin.

Infection is more common in men than women, has a peak incidence in the 20s and 30s, and tends to occur more in summer and with exercise.

A red, scaly rash spreads out from the skin folds in the groin to cover the inside of the thighs, the lower abdomen and the buttocks. It is often itchy and feels constantly uncomfortable. A secondary bacterial infection of damaged skin is possible. The diagnosis proved by taking a skin scraping and examining it under a microscope for fungal spores.

Antifungal creams, ointments, lotions and tinctures are usually effective.

Antifungal tablets are available for more serious infections, but sometimes they are very slow to work, and may need to be taken for up to six months.

The prognosis is good with proper treatment, but recurrences are common.



Togavirus is a family of alphaviruses in the genus Flavivirus that include the viruses responsible for german measles (rubella), yellow fever, dengue fever and some forms of encephalitis. Most are arboviruses (transmitted to humans by an insect bite).



Babies have no control over their bladder or bowels. They simply eliminate their waste material as the organs become full. Around the age of two, the ability to exercise control develops, and gradually, in a combination of both physical development and learning, a child acquires the ability to urinate and defecate only when appropriate. Obviously there is no point in trying to toilet-train a child who is not physically ready to control its bladder or bowels. To try is the equivalent of trying to teach a six month old baby to talk and will simply lead to frustration on both sides.

Parents often feel a child should be clean by the age of two, and dry at night by the age of two and a half. In fact, only about half of all children achieve these goals and many are at least a year later. Complete control is rarely reached before three in any child.

Toilet-training usually starts around 15-18 months by placing the child on a potty after meals. This is the time they are most likely to want to void, and gradually, with much praise if the potty is used, the child will learn that this is what is required. A young child, of course, has no way of knowing what is expected and patience is needed. A child with an older brother or sister who sits on a potty will usually latch on more quickly than a child without such a model to imitate.

Most toddlers react vigorously against being forced into things, and a parent who is aggressively insistent about toilet-training is likely to find the attitude counterproductive. Toilet-training can only succeed with the voluntary cooperation of the child, and if you make the process a battle ground, you are the one likely to lose out.

It is much easier for a child to learn to be clean than dry. Most children only move their bowels once or twice a day, usually at regular intervals. You are likely to be able to recognise the signs of an approaching motion and provide a potty or take them to the toilet to collect it. Generally after a few weeks, especially if you make it clear you regard it as desirable and grown-up behaviour, your child is likely to have become proud of its new skill and will seek out the potty or toilet when it is needed.

Urinating is more haphazard. Children urinate many times in a day and, since it is a less major event, they may

not even notice it if they are absorbed in play. The urge to urinate is also not enough to wake them in the early days of developing control, so they remain used to urinating in their nappy while they are asleep. If a child wakes dry, make the potty available or take them to the toilet and be liberal with praise if it is used.

Gradually the child will learn that when the urge to urinate is felt they should head for the potty or toilet. It is worth remembering that children want to learn and want to acquire new skills - and also that all children do eventually stop wetting themselves, even those who seem impossibly slow. As a rule, the only children who are referred to a doctor because of failure to learn bladder control are those who have been subjected to excessive training. Bed-wetting that persists in an older child is a rather different problem, for which various types of treatment are available.



The triple antigen has been one of the standard vaccinations for children since the 1960s. It contains vaccines against tetanus, whooping cough (pertussis) and diphtheria. It has now been superseded by vaccinations that contain four, five or even six vaccinations against even more diseases (eg. chickenpox, hepatitis B, Haemophillus).

All children should receive the full course of vaccines to protect them against these serious diseases unless there are very good medical grounds not to use them.

The risk of vaccination is infinitesimal, and when compared to the potential side effects of any one of these diseases, it is a far preferable course of action



Triple P (positive parenting program) is a multilevel family intervention system for the prevention and treatment of behavioural and emotional problems in preadolescent children.

The aims of Triple P are:- To promote the independence and health of families by enhancing parents' knowledge, skills and confidence.

- To promote the development of non-violent, protective and nurturing environments for children.

- To promote the development, growth, health and social competencies of young children.

- To reduce the incidence of child abuse, mental illness, behavioural problems, delinquency and homelessness.

- To enhance the competence, resourcefulness and self-sufficiency of parents in raising their preadolescent children.

Doctors and psychologists are trained by Triple P to interact with parents and their children to enhance the behaviour and achievements of the children in line with the desires of the parents. It involves using a number of interventions that deal with a child’s behaviour and the parent’s response to that behaviour.

The program has been remarkably successful and has spread from its home in Australia to many countries around the world and has been adopted by many local and national governments from Iran to Scotland and Japan to the USA as part of their family support service.


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