What to expect, and how to care for your new baby
Congratulations!
You’ve already made the first step towards being an awesome parent!
What to expect in the Hospital:
- Nurses, or even a whole team, will be there at birth to make sure your baby is healthy
- A pediatric “hospitalist” will see your baby daily
- They may check for: low blood sugar, jaundice, signs of infection
- Vitamin K (to avoid bleeding)
- Prophylaxis: eye drops (to avoid eye infection)
- Hearing Screen to check for congenital hearing loss
- “Newborn Screening” = blood sample sent to the State (results will come to us about 10 days later)
- Oxygen Level to check for Congenital Heart Disease
- Immunizations begin: the first dose of hepatitis B vaccine
- Lactation Consultation and/or classes to help with Breastfeeding
***Don’t worry, all babies lose weight… and many will look yellow (jaundice)
***Feeding, Sleeping, Peeing and Pooping (or lack thereof) will become common topics of conversation!
When do I start going to the Pediatrician?
- Within 1-2 days of going home from the hospital
- Call to schedule an appointment if you know you are going home that day
- We want to support you from the beginning, and we know the first week is tough
- The first 1-2 weeks we will continue to monitor feeding, weight, and jaundice
How often will I need to go to the Pediatrician?
Typical well-child visits (“check-ups”) in the first year occur at:
- 3-5 days
- 2 weeks
- 1 month
- 2 months
- 4 months
- 6 months
- 9 months
- 1 year
What to Expect From Your Newborn:
APPEARANCE:
- They were in a tight space until delivery.
“Molding” (weird head) or positional abnormalities (crooked feet) can be normal - Hands and feet may look blue or purple.
Check to see if they are cold and how you have been holding him/her
*Call your doctor if you think your baby’s lips and tongue look blue - Jaundice (yellow color of eyes and skin) is physiologic and may last 2-4 weeks.
*Check with your doctor if it is increasing, or not going away by 1 month - Rashes are common, peeling skin is normal.
Be a minimalist with products the first few weeks
Then choose fragrance-free products (lotions, soaps, detergent, etc.) - Birthmarks are common. They may be brown, pink, red, blue…
*Ask your doctor about it. Some stay, some go away. - Crusty or watery eyes are usually normal.
*Check with the doctor if eyes are red, or lots of eye drainage is present. - Crossed eyes, or wandering eyes are normal until 3 months of age.
Speaking of eyes… all babies have deep blue/grey eyes at birth.
You will see them start to change color between 2-6 months of age - Breast lumps are normal and will go away with time (this goes for girls AND boys)
- Umbilical Cord: slimy at first, and then dries up and falls off (1-2 weeks)
Keep it clean and dry, (alcohol is not necessary)
*Call your doctor if it is draining pus, won’t stop bleeding, or looks infected - Vaginal Discharge is common and normal
- Baby fingernails are soft, but they can scratch and grow fast!
Try keeping them covered with mittens or capped sleeves .
Avoid cutting them until after 1 month of age. - Think your baby is developing a “flat head”?
Do more tummy time, change positions for play and feeding more often.
BEHAVIOR:
- Temperament:
There is no “good” or “bad” baby!
The first week or so they are usually either the “sleepy baby,” or the “feisty, hungry baby”.
Once they get into a rhythm after 2-4 weeks, you will see their true colors. - Feeding Schedule:
First 1-2 weeks: most babies do best eating “ad-lib” (on demand).
Your doctor will let you know if there is a max interval at which you need to wake your baby to feed.
Cluster-feeding happens once they start to gain weight. They may want to eat every hour! Go with it. - Peeing: at least once in the first 24 hours.
Sometimes it looks orange in the diaper after your newborn pees.
(This is not blood, but is a sign your baby may be dehydrated and needs more to eat)
Eventually your infant should have 6-8 full “pee” diapers per day. - Pooping: at least once in the first 24 hours.
First poops are “meconium” = dark green to black, sticky like tar.
“Transitional” poops are lighter green, slimy and sometimes lumpy.
“Normal” baby poop is yellow like mustard and seedy like cottage cheese (yum.)
*Call your doctor if the poop looks white like clay or has blood in it.
Once your baby is feeding well, he/she may poop with every feeding. Eventually after 1 month of age the pooping slows down.
(Anything between 5 to 10x per day, and once every 5-10 DAYS can be normal) - Days and Nights re “confused” for a few weeks… BUT, your baby is NOT confused.
Babies are just not developmentally ready to participate in this loud, bright, chaotic world.
Give it 2-3 weeks, he/she will adjust. - Congestion and noisy breathing are common. Noisy does NOT always equal sick.
If you see boogers, try some nasal saline and then suction his/her nose.
Look at your baby while plugging your ears. If they LOOK comfortable, they probably are.
If your baby can eat, or suck on the pacifier, he/she is probably fine.
If you are still worried, take a video and bring it to your doctor’s appointment. - Sneezing is common, and not a sign of illness or allergies in your newborn
- Squeaks, gasps, wheezes, and coughs are common
- Hiccups happen
- Spit-ups happen
Try burping more, feeding less at a time, laying baby on incline, or holding upright after feeds.
If your baby is happy and gaining weight, he/she is healthy.
Spitting up usually gets better after 3-4 months of age.
Call your doctor if the spitting up is projectile, or is green, or has blood in it. - Babies startle easily. It is a reflex and is normal up to 6 months of age.
*** Babies cry! ** On average, 2-4 hours per day!
Be patient. Never shake your baby.
You will learn what things soothe him/her and eventually what different cries mean.
You cannot “spoil” a newborn. Snuggling and skin-to-skin contact is good. The more, the better!
Babies have a hard time self-soothing until 2-4 months of age. “Crying it out” will not work.
What to Expect As A New Parent:
ALL PARENTS:
- Sleep deprivation
Rest and sleep when your baby is sleeping. - Lots of friends and family calling and texting
Don’t be afraid to ask them for help. Give them chores or shopping lists. - Unsolicited advice (just smile and say “thanks”)
Try to stick to your instincts, pediatrician, and these “baby basics”. - Lots of people that want to come over and hold your baby
Beware of toddlers and germs, try to avoid a lot of visitors.
Nobody comes over sick.
Everybody should be up-to-date on vaccines. - FEAR. There are a lot of “what-ifs,” but being prepared can’t hurt.
Find an Infant First Aid and CPR class- Search your local American Heart Association or American Red Cross for classes
- Select Babies-R-Us provide these classes
- “Infant CPR Anytime” Home Kit for learning the basics:
www.aap.org - Your Pediatric or OB-GYN office may offer classes
- “Big Steps for Saving Small Lives” DVD from CPR Associates of America
MOMS:
- The “BABY BLUES” are real.
- There are a lot of changes in your body and your hormones after birth.
- Most moms describe their mood as chaotic and unpredictable.
- Some moms are flat-out sad.
- If you feel sad, blue, panicky or overwhelmed for more than a few days, call someone to come help.
- Call your doctor.
PARENTS OF BOYS: To circumcise or not to circumcise?
-
- Medical evidence to suggest benefits outweigh the risks
- However, this is truly a personal decision for you and your family to make
- DO: decide before birth
- May be done in most hospitals, or in our office
- Tell someone if there is any family history of a bleeding disorder
- He may need labs checked before the procedure
- The procedure should be done before 1 month of age (if you want it done during infancy)
- I prefer to do them before 1-2 weeks of age
- After the circumcision, the penis will look red and develop a yellowish crust/layer over this fresh skin.
- Apply Vaseline every diaper change
- The area usually heals within 7-10 days
- Call your doctor about bleeding, or a decrease in wet diapers
NUTRITION FOR YOUR BABY: What’s To Eat? Breasts, Bottles, and Pumps, OH MY!
NUTRITION BY THE WEEK:
- Feeding during the first 1-7 days:
- Feed your baby EVERY 2-4 hours, try to pick up on early hunger cues, before he/she starts wailing.
- If breastfeeding, encourage your baby to latch and feed for 15-30 minutes.
- If bottle-feeding, start with about 15ml per feed and slowly increase to about 60ml (for most babies).
- Feeding during the second week:
- Most babies are gaining weight at this point.
- His/her “cues” for feeding become more consistent.
- Hunger cues: sucking, rooting, putting hand to mouth, fussing
- Satiety cues: turning away from breast or bottle, closing mouth, relaxing hands
- He/she may start to “cluster feed”:
- Feeding small amounts frequently (every 20-45 minutes) for 2-5 hours at a time
- (And yes, this will definitely occur in the middle of the night)
- Feeding during the third week and beyond:
- Most babies are back to or beyond their birth weight
- Babies usually fall into a more predictable pattern of feeding (anywhere between every 2 to 4 hours)
TIPS FOR EVERYONE:
Do not give your baby WATER unless instructed by your doctor.
