|- The Newborn|
- Doctor's Visit
- Umbilical Cord
- Legs and Feet
|- Bowel Movements|
- Breast Feeding
- Bottle Feeding
During the next few days after your baby is born, most of your time will be spent in resting & regaining your strength. You can put this time to good use by getting to know some of the simple things which will help make your life with your baby easier and more enjoyable.
Your child is an individual from the day he/she is born. Follow your Pediatrician's advice and do not depend solely on friends and relatives. Dr. Palmos will be happy to give you guidance and answer your questions while you are in the hospital and later during your visits at our office.
Generally, your baby should have his/her first newborn follow-up visit at our office a couple days after you leave the hospital. For your convenience, please call the office for an appointment when you leave the hospital. Your child's second doctor's visit will be after he/she turns two weeks old.
During routine 'well-care' check-ups, your child's Pediatrician will discuss your baby's growth & development, what your child has accomplished and what interesting things you can expect in the months to come.
When you look at your newborn child, you'll notice that his/her head seems larger in proportion to his/her body. For vaginal delivery, it is usually odd-shaped and elongated due to the process of passing through the birth canal. Occasionally, you can feel the ridge of skull bones as they overlap one another. All of these things should straighten out with time and growth.
There are also two (2) soft spots (fontanelles) in an area on top of the head (the larger one) and smaller one at the back of the head that is not yet covered with bone. You don't have to worry about it - the covering is strong and it will not cave in. The large one on top usually closes by two (2) years and the smaller one at the back by two (2) months. Head growth reflects brain growth - this will be closely monitored and followed by your baby's Pediatrician during his/her regular well-care check-up visits. The head of newborns can become 'mis-shaped' if he/she is laid in the same position almost all the time. It is important to rotate your baby's head position by laying him/her on their back or both sides to sleep and on their tummy to play.
The puffiness and discharge on your child's eyes noticed soon after birth are due to the medicine placed in their eyes at birth to prevent infection. When cleaning this discharge, use only water on a clean cotton ball. Avoid the use of any solutions such as boric acid. Wipe from the inner corner of the eye to the outer edge. The puffiness and discharge usually clear in 5 to 7 days.
Many times, tear ducts become clogged in infancy causing some eye drainage. Use a 'warm compress' near the inner corner of the eye several times a day to relieve this temporary obstruction. A gentle massage at the inner corner of the eye may also be helpful.
Your baby’s tongue may normally have a white coating on it, and one or two white spots may be seen on the roof of the mouth. However, notify us if white patches appear on the gums or inside the cheeks. The baby’s upper lip may develop a normal sucking blister.
Some degree of enlargement in the breasts in both male or female infants is not unusual due to maternal hormones. No treatment is necessary for this and the swelling usually subsides in a few months. If however, redness &/or tenderness develop, please consult with us. Do not massage or squeeze your baby’s breasts.
Your newborn infant usually has dry, sometimes scaly skin, occasionally with cracks in the skin around the ankles and wrists. The use of lubricant cream may help when applied once or twice a day especially after bath. This condition should resolve in the first 2 to 3 weeks. You will also notice that rashes seem to come and go on your baby. These rashes will not be limited to the diaper area alone. They also appear over the cheeks, at the hairline, and on the trunk. The majority of these rashes are nothing to worry about and sent nothing other than ‘heat rash’ or minor irritation due to soaps, wool, and even saliva from your baby’s mouth. They are best treated with frequent sponge baths with clear water.
Many dark skinned babies have an area over their buttocks that have a slate blue color. This is not where the doctor slapped your baby to make him/her breathe. It is no more than a normal pigmentation that will fade in time.
You know what & where your baby’s umbilical cord is and probably wonder what to do about it. The answer is simple- very little. Just keep it dry and apply alcohol to it 3 to 4 times a day. Try to keep the edge of the diaper from rubbing on the cord and prevent wet diapers from saturating the area. Before the cord falls off (at about 2 weeks of age), it dries up and looks terrible. Just keep applying the alcohol to the wet area and continue to apply it until the cord comes off and the small amount of bleeding and discharge stops. If the discharge or bleeding persist for more than a few days, bring it to the attention of your baby’s Pediatrician. After the cord falls off and the area underneath is dry, you may give your baby a tub bath. Until then, he/she should only have a sponge bath with warm water and soap. If the navel sticks out a bit when the cord falls off, the baby probably has a small umbilical hernia. This is not at all dangerous. The use of belly bands, adhesive tapes or half dollar taped over the stomach do not cure umbilical hernia or is it helpful in making it go away any quicker. Only time does. When your child begins to sit and later walk, his abdominal muscles will strengthen and in effect, pull the navel into a flat position.
If you have a baby girl, her vaginal area may look swollen to you. This is normal. So is the white, thick, ‘mucousy’ discharge she has; there may even be a small amount of bleeding. You do not have to wipe away that discharge. This is normal & it will gradually disappear without treatment.
If you have chosen circumcision for your little boy, his penis will be red and swollen for the first two to three days. You may also think his penis is so tender it shouldn’t be touched. It isn’t. Just wash his penis with warm water and mild soap, rinse well and pat dry. With the application of A&D ointment or Vaseline to the circumcision site at each diaper change, this will heal in no time.
If your baby boy is not circumcised, the care is the same: wash it with water and soap like the rest of the diaper area.. Don’t try to retract the foreskin of his penis for a while. It is next to impossible to do so at this age. In a few weeks, you may begin to stretch the foreskin by pulling it back. This should be a daily routine. Over a period of a few weeks (3-4), the foreskin will become easy to pull back. It is important to remember to never leave the foreskin in the retracted position as this may cause problems.
All babies have bowed legs when they are born- some more than others. This does not mean that they are always going to be bow-legged. The bowing straightens out with time and with use of legs. You may also notice that most babies feet ‘turn in’ or conversely ‘turn out’. This is due to his positioning in the uterus. With the normal use of his feet and attempts at standing, your baby’s feet will gradually assume normal position.
Some infants may go after every meal. Others may not have a bowel movement for 2-3 days and both are quite normal. A normal stool for an infant should have somewhat the color and consistency of dark mustard and you may see lumps in it. If several consecutive stools should become unusually hard (“formed” stools are not hard), call our office during office hours for current recommendations.
Under normal circumstances your baby’s teeth will erupt without disturbance. However, it is not abnormal for teething to be accompanied by fretfulness, mild diarrhea (1 or 2 looser than usual stools) due to excessive salivation, rash around the mouth or in the diaper area, and rarely, a low grade fever. Generally speaking, if the child is chewing vigorously on hands and toys and has excessive drooling, you can look in his/her mouth and see the gums are slightly swollen over the tooth or teeth in question. Discomfort of teething can be treated with acetaminophen (Tylenol). We do not approve the use of teething lotions and powders. The use of “knobby” rubber or plastic teething rings or the freezable type are helpful. Another very comforting trick is to give your baby a cold, rough terry washcloth to chew on. Keep 4 or 5 damp clean ones in a plastic bag in the coldest shelf of your refrigerator and give him/her a fresh cold one periodically.
Initially, your infant doesn’t know the difference between day or night. Her stomach can hold only enough to satisfy her for three or four hours, regardless of the time, so there’s no escaping round-the-clock waking and feeding for the first few weeks. But even at this age, you can begin to teach her that nighttime is for sleeping and daytime for play. Do this by keeping nighttime feedings as subdued as possible. Don’t turn up the lights or prolong late-night diaper changes. Instead of playing, put her back down after feeding and/or changing her. This will train her to save her extra sleeping for nighttime.
If your baby is rarely alert, does not wake up on her own for feedings, or she seems too tired or uninterested in eating, call our office. This may be a symptom of a serious illness.
The American Academy of Pediatrics recommends that healthy infants be placed on their backs for sleep. For many years it was recommended that infants be placed on their stomach for sleep. This was thought to be the best way to avoid aspiration (sucking food into the trachea or windpipe) in case of vomiting or spitting up. Recent information, however, indicates that the back is a safer position, particularly as it relates to Sudden Infant Death Syndrome (SIDS). This recommendation applies to infants throughout the first year of life. However, the recommendation is particularly important for the first 6 months, when the incidence of SIDS is the highest.
It is also important to avoid placing your baby down for sleep on soft, porous surfaces such as pillows or quilts. Her airway may become blocked if her face becomes burrowed in such surfaces. A firm crib mattress covered by a clean sheet is the safest bedding.
About 1 for every 5 babies have ‘colicky’ episodes, usually between the second and fourth weeks. Colic is more than fussiness; the baby is crying inconsolable, sometimes screaming, drawing his/her legs up and straightening them back out, awake when everyone else is asleep, red-faced, constantly hungry and never satisfied. This usually occurs in the late afternoon or early evening and goes on for hours despite all efforts of the parents to stop it. This pattern reproduces itself daily but usually colic clears up before 3 months of age, even in worst cases.
To a parent who has never been associated with colic before, it can be frightening at first and then very frustrating. No one thing is the single cause of colic in every baby; after hundreds of years of baffling medical science, colic is still largely a mystery. Parents usually are comforted to know, however, that their colicky baby is not in physical pain. Colicky babies are usually big feeders and grow accordingly.
If all else fails, simply leave your baby alone for a while to see if he’ll go to sleep. Don’t allow your frustration to build into anger or panic. A couple of minutes of quiet on the front porch can do wonders for your patience. If you can have someone else watch the baby for an hour or two, it can really help you regain your sense of balance and keep you in a positive attitude.
If you notice that your baby’s cry sounds different (like shrieks of pain) or if it persists for an unusual length of time despite all your efforts, check his/her temperature and/or call us for advice.
Feeding is one of your baby’s first pleasant experiences. The baby’s first love for his/her mother arises primarily from the contact of the feeding situations. The first 2 to 3 days after birth, your baby may be too sleepy and not nurse or take a bottle well. This is normal and his/her appetite will gradually increase. The baby need not be put on a ‘schedule’ at first. Generally, you should not feed your baby more frequently than every 2 hours or less than every 5 hours during the day. The child need not be awakened at night for feeding. Water may be offered between milk feedings. Babies need not be fed every time they cry.
We strongly encourage any mother to breast feed if she has the desire or interest to do so. Breast milk is perfectly balanced to suit your baby and intolerance is extremely rare. Also, it provides certain minerals and vitamins that aid in digestion (that formulas try to include), as well as enzymes and antibodies (that help protect against illness) that can be found in mothers milk. Breast feeding may decrease the risk of developing allergies. The American Academy of Pediatrics recommends breast feeding for the first year of your baby’s life.
The key to successful breast feeding is to relax and take things as they come. Nature will usually take care of the rest. Remember, nursing your baby is a learned art. We suggest you read some ‘handbooks for the nursing mother’ that are readily available in your local bookstores.
A nursing mother should take very good care of herself. She needs to get plenty of sleep, continue her prenatal vitamins, and drink lots of water. She should eat a well-balanced diet and should not go on a diet to lose weight as the baby may not receive adequate nutrition. A nursing mother should not take any medications (prescription or over-the-counter) without checking with her doctor. Smoking or alcohol consumption while breast feeding is strongly discouraged.
The main advantage of formula-feeding is that it frees Mom from being the only source of her baby’s food. This gives a new mother more flexibility and helps everyone else in the family bond with the baby.
Iron fortified formulas are recommended for all bottle-fed babies from birth to one year. There are a wide variety of milk formulas on the market. These formulas offer excellent substitute for breast milk as the fats, carbohydrates, proteins, minerals and vitamins have been carefully adjusted to resemble the composition of human milk.
Most babies will take 2-4 ounces 3-4 hours, but this, like everything else, can vary. You should be comfortable to get the most out of feeding your baby. Cradle your baby in a semi-upright position and support his/her head. Do not feed him when he is lying down because this will increase the risk of choking. Hold the bottle so the formula fills the nipple of the bottle before giving it to him. This will prevent your baby from swallowing too much air. To get him to pen his mouth, stimulate the ‘rooting reflex’ by stroking the nipple against the cheek near his mouth. Never prop up a bottle in your baby’s mouth and leave it there, and never put your baby to bed with a bottle. Don’t forget that your baby needs the security & pleasure it gives him to be held at feeding time. It’s a time for you to relax and enjoy each other.
Both breast-fed and bottle-fed babies sometimes swallow air during feedings and tend to get fussy and cranky when this happens. Frequent burps will help with this problem. If your baby is bottle feeding, burp her after every 2 to 3 ounces. A nursing baby should be burped each time the Mom switches breast. If your baby doesn’t burp after several minutes, continue feeding him and try again when he finishes. Don’t worry. No baby burps every time.
There are good ways to burp a baby. One way is to pat the baby’s back while holding him upright over your shoulder. Another way is to hold him in your lap in a sitting position slightly leaning over your hand, which is positioned to support baby’s head (usually baby’s chin is resting on your hand between thumb and index finger.) You may also lay the baby’s face down across your lap and pat the baby gently on the back.
Spitting usually occurs in all babies at one time or another; some babies are destined to spit after almost every feeding no matter what. Other babies respond dramatically to simple alterations in feeding technique.