- Newborns tend to feed-on-demand. For the first few days, try to feed the baby at least every 3 hours. After that, some babies will occasionally have longer periods between feedings, but try not to let him go more than 4 hours without trying to feed.
- We encourage breast-feeding. Try to encourage at least 10 minutes per breast to allow the fatty milk at the back of the breast to be let down. Feel free to allow your child to feed until he is full. However, if he is falling asleep while nursing he might be using you as a pacifier. This can lead to nipple soreness. If you are having trouble breastfeeding you can check out La Leche League www.llli.org or ask us for a referral to a lactation consultant.
- Some mothers prefer not to breast-feed. Infant formulas are perfectly acceptable in this case. Please use an iron-fortified formula. Powdered formula is just as good as pre-made and much cheaper. Do not heat bottles in the microwave – use a pan of warm water.
- It is now recommended to supplement 400 IU Vit D (i.e. Trivisol infant vitamins) for all babies. As a alternative breastfeeding mothers can take 6,000 IU of Vit D.
- Some degree of “spitting up” is normal for most babies. They tend to outgrow it by 6 to 9 months of age. It usually requires no treatment. However, if the vomiting is very forceful or “projectile”, give us a call.
- Many parents of newborns report their babies seem gassy. This is perfectly normal and no medication is needed.
- Many babies develop some degree of jaundice or yellowing of the skin. It often progresses gradually over the first few days of life, peaks by day 4 or 5, and then starts to resolve. As jaundice increases in severity it progresses down the body from head to toe, so that the lower down it is, the worse it is. Babies get rid of jaundice by eliminating the chemical bilirubin in the stool. So frequent feeding and stooling will help. If you notice increasing jaundice (especially of the eyes) after you’ve gone home, give us a call.
- Try to avoid contact between your baby and people with an illness or cold sores. These infections could lead to significant illness in your child. Before people handle the baby they should wash their hands. It’s a good idea to have a bottle of hand sanitizer in the diaper bag.
- Hiccups and sneezing are normal. Jitters when startled are also normal. They are part of the baby’s immature nervous system and generally resolve by 2 to 3 months of age.
- Newborns often have some degree of nasal congestion, often present for 1-2 months after birth. Usually no treatment is needed, but if it’s making the baby uncomfortable, you can try some nasal saline drops, such as Ocean Spray or AYR. Place 2 drops into one nostril, wait 15-30 seconds, and then bulb suction that nostril and repeat the process for the other side.
- Fever is especially worrisome in an infant less than 2 months old. If your less than 2 month old baby has a rectal temperature above 100.4, please call us right away, day or night.
- Rashes are common. Little white spots on the nose, milia go away with time. Red circles (sometimes with yellow bumps) called erythema toxicum typically fade around 7 days.
- Having a baby is a great incentive to quit smoking if you smoke. Even smoking outside exposes your baby to harmful chemicals that are carried on your clothing. We can refer you to a program Quitworks to help you quit if you desire to make this healthy change for you and your family.
- Babies normally sleep18-20 hours a day. In the first few weeks, their wakeful hours are spent mostly eating.
- Nighttime sleep habits vary in babies. Most babies do not sleep through the night until 4-6 months of age. Some sleep for longer stretches than others initially. Please feel free to discuss your questions with us.
- Most importantly, please remember to place your child on her back to sleep. Never place your infant on her stomach to sleep. [This recommendation has been found to decrease the risk of Sudden Infant Death Syndrome (SIDS or “crib death”).]
GROWTH & DEVELOPMENT
- Babies typically double their birth weight by 6 months of age and triple it by 1 year. This is the period of most rapid growth. Growth spurts are often accompanied by increased hunger in the infant.
- Your baby can already focus on objects within 12 inches of her face. She likes to look at faces and the contrast of light and dark objects.
- Your infant should respond to sounds and smells. Although he can respond to sounds, he will not be able to distinguish from where the sounds came.
- You can’t spoil a baby in the first few months of age, so feel free to hold her as much as she seems to need.
- Babies typically can’t roll over until 3 to 4 months of age, but sometimes they manage to do it on occasion much sooner, so be mindful not to leave him unattended on a changing table, bed, or sofa.
- Crib and bassinet mattresses should be firm and any sheets should fit snugly to the mattress. Avoid blankets or fluffy things that the baby could get her face stuck in.
- It’s safer not to have hot liquids around the baby. You never know when you might have a spill.
- Use an approved car seat correctly at all times, facing rearward until at least 2yrs of age or they reach height and weight allowed by car safety seat’s manufacturer ( see attached car seat guidelines). The seat belt should be secured firmly holding the baby in place and the car seat belt buckle should be at the level of the baby’s armpits. You can have your car seat checked: http://cert.safekids.org
- Keep plastic bags, pillows, safety pins, buttons, stuffed toys, and talcum powder out of the baby’s crib and hands.
- Do not use a microwave oven to warm the baby’s bottle as it heats the fluid within the bottle unevenly, leading to “hot spots” in the liquid which can burn the baby’s mouth. Rather, place the cool bottle in a dish of hot water and let it warm slowly. Test the liquid’s temperature prior to giving it to your baby.
- A baby’s skin can burn easily in the sun. Avoid direct sun exposure and use hats, sunshades, and umbrellas to keep the sun off the baby.
- Your hot water thermostat should be set below 120 degrees F to prevent accidental burn injuries.
- Smoke detectors and carbon monoxide detectors should be present in your home.
- Post-partum depression is common. If you are feeling down contact us or your doctor for help. If you feel unsafe towards yourself or your baby call 911 or proceed to the emergency room.
- Never shake a baby. It can cause permanent damage and death.
Vaccines and your child: Separating fact from fiction. Paul Offit, MD
The American Academy of Pediatrics New Mother’s Guide to Breastfeeding. Joan Meek, MD
Touchpoints – Birth to Three. T. Berry Brazelton, MD
Caring for your baby and young child, American Academy of Pediatrics.
Baby 411. Ari Brown MD
La Leche League www.llli.org Breastfeeding support
CDC Vaccine Page www.cdc.gov/vaccines
Domestic Violence Hotline 800-799-SAFE (7233)
Food Assistance WIC 1-800-WIC-1007 and SNAP www.mass.gov/snap
www.healthychildren.org Site by pediatricians about variety of health topics
App: Pediatric Symptom MD – variety of pediatric advice