Having a newborn baby is filled with so many emotions. The excitement can be mixed with confusion and anxiety. Somewhere along the way, having a baby has become a complicated process, and the newborn manuals have become textbooks. However, we make it our goal to simplify it for you.
To start, here are some common questions that we have received over the years and basic answers to help you. We firmly believe that all questions are welcome. We are here to help you out. We are here to guide you through the wonderful experience of becoming a parent and help you build the confidence along the way.
When do I see the pediatrician? When should I bring my baby in for an appointment?
Once you go into labor and check into the hospital, simply inform them that you choose our office as your pediatrician. The pediatrician is generally not at the delivery, but a pediatrician who is on call for the hospital will examine your baby once a day while you are in the hospital. If your baby is born vaginally the typical stay is 2 days and if born by C-section then the stay is typically 3 days. Please call us and notify our office once your baby is born. After you are discharged we will schedule an appointment to see your baby within 2 to 3 days to make sure everything is going well and your baby is healthy. It is a good idea to schedule this appointment before you go home from the hospital.
What about well infant visits during the first year? How often and what is expected?
After the first visit, we will see your baby at 2 weeks, 1 month, 2 months, 4 months, 6 months, 9 months, and 12 months. At these visits we will discuss feeding, growth, development, safety issues, vaccinations, things to expect and more. We welcome questions. We are here to educate and give you guidance. All babies are unique and we are here to help sort out what is normal and what could be a concern.
What should I expect with feedings?
If you are breast feeding, attempt feeds every 2 to 3 hours. Don’t be frustrated if your milk doesn’t come in right away. It may take four or five days. Try for at least 8 feedings a day. Some babies will eat as many as 12 times per day in the first few weeks. The more you attempt nursing, the quicker your milk will come in.
If you are formula feeding, offer 2 to 3 ounces every 2 to 3 hours. It is ok to give a little more if your baby wants more. Look for cues such as rooting, when they turn and move their lips, to suggest hunger.
Make sure formula is mixed appropriately with 1 scoop of formula per 2 oz. of water or per package instructions. Tap water or bottled water is preferred. Do not use well water.
A single 4 to 5 hour stretch without feeding is acceptable once nightly in the first few weeks of life.
Many babies spit up after feedings. This is normal and expected. It usually looks worse than it is. If you think your baby is spitting up too much or he or she is having trouble feeding, we will be happy to discuss this during an office visit.
Also, don’t panic if your baby loses weight over the first few days. This is normal and expected. We will monitor your baby’s weight gain to make sure it is appropriate.
How many wet and poopy diapers should my baby have per day?
Expect about 1 wet diaper on first day of life, 2 on the second, 3 on the third, 4 on the fourth, 5 on the fifth. After this expect 6 to 8 wet diapers per day.
Expect black, sticky, tar-like stools within 24 to 48 hours after birth. You will then see a transition to yellow, brown or green stools over the next few days.
Some babies poop a lot. It is not unusual for a breast fed newborn to have ten or more yellow, seedy, mustard-like stools a day. However, some babies do not poop that much and this also can be ok. Babies do not have to poop every day. Some babies only poop once or twice a week and this can be very normal.
Some babies turn bright red and grunt when they poop. This is normal too. Trouble pooping is only a concern if there is blood, the poop is extremely hard, or if the baby is inconsolable.
Does my baby need anything other than breast milk or formula in the first 6 months of life?
In most cases, no. Most of the time, we do not recommend solids until 6 months of age for babies that are exclusively breast fed. In certain circumstances, we may recommend solids at an earlier age.
The one nutrient your baby may not be getting enough of is Vitamin D. Because Vitamin D does not pass easily into breast milk, breast fed babies will not receive the recommended daily value. Please ask your pediatricians for recommendations of over the counter Vitamin D supplements that are available.
How do I keep my baby from getting sick?
This is extremely important, especially during the first two months of life when your baby’s immune system is still developing. Make sure all friends and family members, including you, wash hands thoroughly and/or use hand sanitizer before touching your baby. This is the best way to reduce the spread of infection.
Keep your baby away from any sick people. We want to avoid even a simple cold because colds can cause fevers, and fevers can be indicative of more serious infections. If your baby has a temperature over 100.4 (rectally) in the first month, you will need to go back to the hospital for tests, and we want to avoid that if at all possible.
Should I be concerned that my baby is crying a lot?
Know that it is normal for babies to cry, sometimes a lot. Try to explore what provides comfort for your baby. Swaddling and holding can often help, as can gentle swaying. Soft music and rocking works sometimes, too. Sucking is comforting, either when feeding or with a pacifier if you choose to use one.
Some babies who cry a lot have a condition called “colic”. Unfortunately colic is not well understood. If you feel that your baby cries too much or is hard to console, we can discuss at an office visit and discuss ways to help calm your baby.
What if my baby doesn’t cry?
While some babies cry a lot, others do not. Consider yourself lucky. However, if you’re blessed with a calm, sleepy baby, you may need to stimulate him or her to wake for feedings. Do not be afraid to use a cool wash cloth to rub on your baby’s face or chest to wake him or her. You can also move the baby’s arms or legs. If you ever cannot arouse your baby at all, this may be a sign of illness, and you should seek medical attention.
My baby does some strange things. Is this normal?
Babies are amazing, but often do some things that look abnormal. Here are some examples of common behaviors that are completely normal and expected.
Babies sneeze. This is normal. Babies also hiccup. You may have noticed this in utero. This too is normal.
Babies sometimes shake or quiver their arms, especially when startled or when sleeping- this is a normal neurological reflex. It is not a seizure.
Babies will sometimes appear to breathe in a strange way. They will breathe very quickly for a brief time, and then breathe very slowly taking pauses between breaths. This can be normal, but if you feel your baby is ever having difficulty breathing it is important to seek medical attention immediately.
Babies can have a watery or yellow eye discharge caused by a blocked tear duct. This may look like an eye infection and can be very confusing. If your baby has an eye discharge, let us look at it to determine if it is a true infection or just a blocked duct. If it is just a blocked tear duct, we can teach you how to remedy it.
Babies don’t see well initially. Do not be surprised if he or she looks cross-eyed. This is normal.
Babies can have a lot of unusual rashes or birthmarks, especially right after birth. Some babies have red splotches that look like insect bites. Other babies may develop baby acne or white spots on their face. Most of these rashes are benign and will resolve with time. Remember, you can always ask us to look at a rash if you have any concerns.
How should I care for my baby’s umbilical cord?
Babies are born with a jelly-like umbilical cord that quickly dries up. It usually will fall off in 7 to 14 days. Until it falls off, you should sponge bathe your baby rather than submerge him or her completely. Try not to get the cord wet. You do not need to use alcohol on the cord. When the cord falls off, the belly button may look green and yellow and it might even bleed a little bit. That is ok. Then you can use a washcloth to clean the area. Let us know if it becomes very red or has a foul odor.
My son had a circumcision. What do I need to do?
The penis will look very red and raw for a few days. There will often be some yellow discoloration on the head of the penis. This is a normal part of a healing circumcision, and it will resolve in 1 to 2 weeks. Use petroleum jelly to help prevent the penis from sticking to the diaper until the circumcision is healed.
I noticed my baby girl has some vaginal discharge. Is this normal?
Sometimes baby girls have a white, mucus-like vaginal discharge or some mild spotting. This can be normal and is not an infection. This is caused by withdrawal from maternal hormones after delivery.
When does my baby get his or her vaccinations?
We believe that timely vaccinations are very important in preventing disease and keeping your newborn healthy; however, we also believe it is important for every parent to understand what the vaccines are for and why we are giving them. We understand there is a lot of information and mis-information about vaccines out there and encourage you to ask us questions. The first vaccination is offered in the hospital and is to help prevent hepatitis B. The next vaccinations will occur in our office. We will be happy to review the full vaccination schedule in detail.
In addition to vaccinating your baby, we feel strongly that proper vaccination of parents and caregivers can help protect their baby from serious infections. Specifically, the Pertussis (whooping cough) and Influenza vaccines are recommended for anyone in close contact with a newborn infant. We can provide these vaccines in our office if you are interested. Please let us know if you want to establish yourself as a patient as well.
What if I feel too overwhelmed or start to feel depressed?
Having a baby can be very emotional and stressful, especially for new mothers. It is important for all members of the family to help each other out. It is not uncommon for some moms to experience post-partum ‘blues’ or even depression. Keep an open dialogue with your friends and family and have a plan in place when breaks are needed! Try to set up a good social support system. We are here to talk to you when you need us. If you feel the need for help, please make an appointment as we can take care of moms and dads too.
OK, so I think I’ve got it . . . but when should I call the office?
- First of all, you can call us anytime during regular office hours for routine questions.
We have trained clinical staff who can help answer many of your concerns. No question is too silly or small. We want you to feel completely comfortable with your newborn.
We also have a patient portal, which is an excellent way to ask questions electronically. We do our best to answer as quickly as possible.
- Of course, you can always make an appointment to talk to us in person.
- As far as contacting our office after hours, there are a few things that warrant a call immediately.
- * Anytime there is a fever greater than 100.4 (rectally) in the first 2 months of life.
- * Your baby is lethargic and will not awaken for feeds, despite undressing and stimulation.
- * Your baby has consistent poor feeding, refusing the bottle or breast.
- * Your baby has an increasing yellow skin discoloration during the first week of life
- * Your baby is inconsolable, constantly crying or cannot be calmed for more than 3 hours.
- * Your baby has a significant decrease in wet diapers.