CAR SAFETY
Use a rear facing car seat in middle of the back seat. Never place baby in front seat with a passenger side air bag. Make sure seat is properly installed. Never leave your child alone in the car.
FEEDING
Newborn babies need to be fed at least every 2-3 hours. If your baby is fussy, sucking on their fist, or turning their head toward you when they are held, they may be hungry and you should try feeding them. At this age, your baby will not overeat. We will check your baby's weight in the office to make sure he or she is gaining weight normally. Until then, if your baby is making at least 6-8 wet diapers per day, she is likely getting enough to eat.
Breast-fed babies typically nurse for 10-15 minutes on each breast. You should try to alternate which breast you start feeding with and try to feed from that side until the milk is gone. The last milk to come from the breast is the highest in fats which are important for your baby's growth and development.
Formula fed babies may take as little as 1/2 ounce per feeding at first but may work up to 2-3 ounces per feeding quickly, sometimes as soon as a few days old. Powdered formula should be mixed one scoop to 2 ounces of tap water. If you have city water, we recommend using tap water (it does not need to be boiled). Do not change formulas without discussing it with your doctor first.
Don't warm bottles in microwave - this can overheat or cause "hot spots" that can burn your baby.
FUSSINESS (CHANGING FORMULAS)
Infant formulas such as Enfamil and Similac have been developed and tested over decades, helping millions of babies grow world wide. They are proven safe and effective at promoting optimal growth with no nutritional deficiencies. It is best to start out with one brand and stick with it. As your baby grows week by week, minor problems may develop such as constipation, "gassiness", or periodic fussing. It is tempting to try a different formula but this is rarely the solution. Most gassiness in newborns is developmental and will improve naturally within 2-3 months. If you have any concerns, speak with our trained nursing staff or schedule an appointment to have your baby examined. Occasionally, problems do exist and your baby may require medication or a change of formula.
VITAMIN D
All infants should receive 400 IU vitamin D per day, or 1 mL DiViSol per day. All exclusively breast-fed infants should receive 1 mL DiViSol per day. This recommendation is based on the low vitamin D content of breast milk and the disproportionately high frequency of rickets among exclusively breast-fed infants. Most formula-fed infants should also receive 1 mL DiViSol per day. Currently, fortification practices in the United States ensure that infant formulas contain at least 400 IU vitamin D per liter (33oz). Thus, formula-fed infants who consume less than 33oz formula per day require vitamin D supplementation to meet the current AAP standards for vitamin D intake.
STOOLS
If you have concerns about your baby's bowel movements, you are not alone. This is one of the most common reasons for a call to our office. For the first few days, baby's stools will be very dark, sticky meconium. It is an important sign that your baby passes the first meconium during the first 24 hours of life. After each feeding, milk moves through the GI tract, resulting in the stool color changing from black to brown (transition stool) to yellow. If this transition does not take place, speak with our trained nursing staff or schedule an appointment to have your baby examined. Once this transition does take place, most newborns continue to have frequent bowel movements, likely after each feeding. Breast fed baby’s stool are usually soft, yellow and seedy. Formula fed baby’s stools are firmer and brown.
After the first few weeks, you can expect the frequency of stools to slow down. This typically occurs between 2 weeks to 2 months of age. Your baby may have a bowel movement once a day, once every other day or even once every 3-4 days. If less than 2 weeks old, touch base with our office if no bowel movement for 24 hours. If more than 2 weeks old, touch base with our office if no bowel movement for 5 days. If your baby has not had a bowel movement in several days but is alert, active when awake, eating way and no more fussy, it is unlikely that there is a serious problem. It is normal for infants to feel pressure, grunt and turn red while having bowel movement In younger babies, the involuntary muscle coordination that makes passing stools easier for older children and adults isn't yet fully developed, and so they may use mild fussing or grunting to help push stools out. Call the office if prolonged crying, vomiting, firm distended abdomen, blood in the stool, or lethargy. Hard stools present a different problem, and may require some sort of treatment. There is no need for your baby to be uncomfortable with large caliber or hard stools, or stools that cause a streak of blood on passage. If your baby is over two months of age, you may offer your infant 1-2 ounces of juice twice a day. We don't typically introduce juice at this point but as a medication, it is appropriate.
BLADDER
Normal babies who are not dehydrated will produce at least 6 to 8 wet diapers per day. In baby boys, a normal urine stream has a strong immediate flow that comes in a straight line from the penis.
BATHING
Give sponge baths until the umbilical cord falls off to avoid infection. Getting it a little wet doesn't matter. Use lukewarm tap water with no soap or baby soap. Don't forget to wash the genital area, but don't use soap for girls since it may irritate the area. Be careful! Wet babies are slippery-it may be useful to lay them on a towel while bathing.
SKIN CARE
Newborn skin normally does not require any ointment or cream. Peeling skin is normal in the first 2 weeks of life and does not mean your baby has dry skin. However, if the skin becomes red and cracked, use a thick cream like Eucerin or Cetaphil. If the baby's diaper area becomes irritated, you can use a cream such as Original Desitin or A&D Ointment. Avoid talcum powder because it can cause serious pneumonia if inhaled into the lungs.
UMBILICAL CORD
Try to keep the cord dry. Air exposure helps dry the cord, so keep the diaper folded down below the cord area. It is not unusual for the cord to have an unpleasant odor but if the skin around the cord becomes red, call your pediatrician.
NAIL CARE
Cut the nail straight across using clippers or special baby scissors, or use a nail file to keep your baby's nails reasonably short. Trim them frequently to prevent unintentional scratches.
TAKING TEMPERATURE
You do not need to take your baby's temperature unless he/she feels warm or is acting sick. A rectal temperature is the most accurate. First, lubricate the end of the rectal thermometer with petroleum jelly. Then have your child lie stomach down on your lap and carefully insert the thermometer about 1 inch into the rectum. Never force it. Press the buttocks together to hold the thermometer in place for 2 minutes. If the temperature is above 100.3° F, call your doctor. Do not give Tylenol or Motrin before seeing a doctor.
SLEEP POSITION
Always put your child to sleep on his back in a crib or bassinet. This is because studies have shown an increased risk of Sudden Infant Death Syndrome (SIDS) in babies who sleep on their bellies. Avoid use of pillows, blankets, or stuffed animals in the crib. Babies who sleep with their parents, or whose parents smoke, are also at an increased risk for SIDS or accidental suffocation.
CRYING MANAGEMENT
Never shake a baby no matter how angry or frustrated you feel. Shaking can cause brain damage or death. Try feeding, burping, changing the diaper, offering a pacifier, taking the baby for a walk or car ride, or enlisting the help of family or friends. If these ideas don't work, call your doctor.
HOME TEMPERATURE
The house temperature is best kept at 70-72 °F in the winter, especially in the first month. A newborn may be prone to loss of body heat due to drafts or spending time near a cold window.; A term baby should not require a hat once you are home from the hospital. You may dress your baby slightly warmer than you are dressed inside your home and while sleeping. Keep in mind not to overdress or over-bundle your baby, as this may lead to heat rashes. As early as 2 weeks old, your baby is better insulated from the cool air and able to be dressed similar to the way you are dressed. Room temperatures of 68-70 °F may be best, as over warming young infants has even been listed as a risk factor for sudden infant death syndrome (SIDS).
