What to expect, and how to care for your new baby
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:
- 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.
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:
- 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:
- Your Pediatric or OB-GYN office may offer classes
- “Big Steps for Saving Small Lives” DVD from CPR Associates of America
- 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.