Newborns
By Dr. Brown
Congratulations! You may be feeling overwhelmed with both excitement and fatigue! Despite all the activity and visitors, be sure to get your sleep. An overtired parent isn't as good to a baby as a well rested one!
The doctors will probably want to see your newborn within the first few days after discharge. At this first visit we will check your baby's weight, assess feeding, check for jaundice, and might administer an immunization.
Emergencies/Things to Report:
- Jaundice, or yellowing of the eyes or skin
- Rectal Temperature of 100.5 or greater
- Refusing to eat for several feedings in a row
- Blood in the stool, especially if your child seems uncomfortable
- Vomiting that is "projectile" in nature; not just spitting up
- Excessive crying
Things that are Probably Normal:
- Hiccups: try a sip or two of water to stop these
- Sneezing and intermittent "congested" sounds : try running a humidifier or sitting in a steamy bathroom to alleviate
- Crying: try the usual - feeding, comforting, changing diaper, etc
- "Jitters" or "Shakes" that last just a few seconds : if the "shakes" are worsening or your baby appears unusual or "out of it", please let us know
- "Cross-eye" appearance that is intermittent : if the crossing is becoming more frequent or "fixed", let us know
- A little oozing, blood, or yellowish discharge from your baby's navel cord if there's redness of the skin around the navel that seems to be growing, or the area seems tender, please let us know; as the cord falls off, you may see a little blood or more ooze - this is probably normal; most cords fall off in 7-14 days, our office record is 58 days!
- A white to yellow vaginal discharge; occasionally there may be blood: it's best to probably leave this alone unless there's an excessive amount; remember to wipe from front to back
- Slight eye discharge or crustiness : if the white of the eye is red, the lids are swollen, or the discharge is copious, let us know
Sleep
Babies should be put to sleep on their backs. Things like side position devices are probably not necessary. Although your baby will like to sleep in your arms, its important to get the baby to learn to sleep by themselves in a crib or bassinet. "Co-sleeping" is discouraged. Pillows and heavy blankets should not be placed in the crib; its best to put your baby in a heavier sleeper if you need to. Babies sleep on average about 18 hours a day, but the range is variable.
Room Temperature
Keep the room as comfortable as you would like it. If your baby seems irritable or too sleepy, this may mean the temperature is not right.
Bowel Movements
Your baby's bowel movements will vary. The first several bowel movements will be a dark sticky substance known as "meconium". These may last for a few days and then turn to a more greenish color, eventually turning yellow or brown or green. The bowel movements may be almost pure water, pasty, seedy, or slightly formed - these are all normal bowel movements. If you see blood or the bowel movements are so hard that they hurt the rectum, let us know.
Umbilical Cord Care
Apply a little bit of isopropyl (rubbing) alcohol on the base of the navel with each diaper change. If you forget or never apply the alcohol, this will probably be fine; the alcohol helps to keep the area cleaner, less smelly, and enables it to fall off quicker. As mentioned previously, its common to see a little ooze or blood as the cord is ready to fall off; keep applying the alcohol. No soaking baths until the navel has fallen off, then wait a few extra days of drying.
Circumcision / Non-Circumcision Care
If your son has been circumcised, you'll need to apply a gauze with petroleum jelly over the head of the penis to keep it moist; this will probably be about 5-6 days. No soaking baths until the circumcision has healed and the navel cord has fallen off.
If your son has not been circumcised, do not try to retract the foreskin. When its ready to, when your son is older (3 top 6 years of age), the foreskin will be able to retracted without a problem.
For further details, see "Circumcision Aftercare" on our website in the Patient Education Resources section.
Water
Except for a few sips to help interrupt hiccups, your baby does not need extra water. Both breast milk and formula should provide enough water for your baby.
Pacifiers
The doctors agree that pacifiers are fine for babies, if you so wish. Babies have an inherent need to suck. Let your baby enjoy this sensation. We've never seen pacifiers "mess up" breastfeeding. However, the first week or so, its probably best to downplay the pacifier in order to maximize stimulation to the breasts to promote milk production. A good time to try to get rid of the pacifier is from 4 to 6 months of age. More information on Pacifiers.
Vitamins
Your baby may or may not need vitamins. The typical vitamin for breastfed babies is called Polyvisol with Iron. The doctor will discuss this with you.
Safety
Please don't leave your baby unattended on the changing table or anywhere else that he may fall. Some babies begin to roll over at this age. Always use your car seat, and watch where you put the seat as it can be tipped over if put on a table or counter.
Always check water temperature before bathing your baby. You may want to consider lowering your hot water heater temperature to 120 degrees for safety.
Routines
Sleeping: If discussed with your doctor, try to encourage your baby to sleep for longer periods at night and shorten the intervals during the day. More information on sleeping suggestions.
Feeding: If discussed with your doctor, try to get your baby to be an efficient and strong feeder during the day by keeping him or her "on task". At night, see if you can try to "get by" with as little as the baby needs. More information on breast feeding.
Rhythms/Cycles: The best rhythm to get your baby on is to have her eat soon after waking, stay up for a while (if possible), then go to sleep by herself; in other words - try to not feed her to sleep.
Stimulation: Try to tone down some of the daytime stimulation for your baby the first few weeks and as he or she begins to be more wakeful during the day, you can begin to increase the daytime stimulation.
Infant Development
Don't forget to give your baby lots of supervised "Tummy Time". This only has to be for a short time, but you should do this several times a day.
Babies can not see color at this time, they prefer to see sharp contrast items. If you have any black and white picture cards or rattles, hold them about 12-14 inches away from your baby for sharpest focus. You may also go to the following website and print some patterns from your computer:
http://baby.zorger.com/baby.zorger.com.newborn.pdf
or
http://babystrology.com/baby-learning/infant-visual-stimulation/infant_visual_stimulation.pdf
Congratulations! You may be feeling overwhelmed with both excitement and fatigue! Despite all the activity and visitors, be sure to get your sleep. An overtired parent isn't as good to a baby as a well rested one!
The doctors will probably want to see your newborn within the first few days after discharge. At this first visit we will check your baby's weight, assess feeding, check for jaundice, and might administer an immunization.
Emergencies/Things to Report:
- Jaundice, or yellowing of the eyes or skin
- Rectal Temperature of 100.5 or greater
- Refusing to eat for several feedings in a row
- Blood in the stool, especially if your child seems uncomfortable
- Vomiting that is "projectile" in nature; not just spitting up
- Excessive crying
Things that are Probably Normal:
- Hiccups: try a sip or two of water to stop these
- Sneezing and intermittent "congested" sounds : try running a humidifier or sitting in a steamy bathroom to alleviate
- Crying: try the usual - feeding, comforting, changing diaper, etc
- "Jitters" or "Shakes" that last just a few seconds : if the "shakes" are worsening or your baby appears unusual or "out of it", please let us know
- "Cross-eye" appearance that is intermittent : if the crossing is becoming more frequent or "fixed", let us know
- A little oozing, blood, or yellowish discharge from your baby's navel cord if there's redness of the skin around the navel that seems to be growing, or the area seems tender, please let us know; as the cord falls off, you may see a little blood or more ooze - this is probably normal; most cords fall off in 7-14 days, our office record is 58 days!
- A white to yellow vaginal discharge; occasionally there may be blood: it's best to probably leave this alone unless there's an excessive amount; remember to wipe from front to back
- Slight eye discharge or crustiness : if the white of the eye is red, the lids are swollen, or the discharge is copious, let us know
Sleep
Babies should be put to sleep on their backs. Things like side position devices are probably not necessary. Although your baby will like to sleep in your arms, its important to get the baby to learn to sleep by themselves in a crib or bassinet. "Co-sleeping" is discouraged. Pillows and heavy blankets should not be placed in the crib; its best to put your baby in a heavier sleeper if you need to. Babies sleep on average about 18 hours a day, but the range is variable.
Room Temperature
Keep the room as comfortable as you would like it. If your baby seems irritable or too sleepy, this may mean the temperature is not right.
Bowel Movements
Your baby's bowel movements will vary. The first several bowel movements will be a dark sticky substance known as "meconium". These may last for a few days and then turn to a more greenish color, eventually turning yellow or brown or green. The bowel movements may be almost pure water, pasty, seedy, or slightly formed - these are all normal bowel movements. If you see blood or the bowel movements are so hard that they hurt the rectum, let us know.
Umbilical Cord Care
Apply a little bit of isopropyl (rubbing) alcohol on the base of the navel with each diaper change. If you forget or never apply the alcohol, this will probably be fine; the alcohol helps to keep the area cleaner, less smelly, and enables it to fall off quicker. As mentioned previously, its common to see a little ooze or blood as the cord is ready to fall off; keep applying the alcohol. No soaking baths until the navel has fallen off, then wait a few extra days of drying.
Circumcision / Non-Circumcision Care
If your son has been circumcised, you'll need to apply a gauze with petroleum jelly over the head of the penis to keep it moist; this will probably be about 5-6 days. No soaking baths until the circumcision has healed and the navel cord has fallen off.
If your son has not been circumcised, do not try to retract the foreskin. When its ready to, when your son is older (3 top 6 years of age), the foreskin will be able to retracted without a problem.
For further details, see "Circumcision Aftercare" on our website in the Patient Education Resources section.
Water
Except for a few sips to help interrupt hiccups, your baby does not need extra water. Both breast milk and formula should provide enough water for your baby.
Pacifiers
The doctors agree that pacifiers are fine for babies, if you so wish. Babies have an inherent need to suck. Let your baby enjoy this sensation. We've never seen pacifiers "mess up" breastfeeding. However, the first week or so, its probably best to downplay the pacifier in order to maximize stimulation to the breasts to promote milk production. A good time to try to get rid of the pacifier is from 4 to 6 months of age. More information on Pacifiers.
Vitamins
Your baby may or may not need vitamins. The typical vitamin for breastfed babies is called Polyvisol with Iron. The doctor will discuss this with you.
Safety
Please don't leave your baby unattended on the changing table or anywhere else that he may fall. Some babies begin to roll over at this age. Always use your car seat, and watch where you put the seat as it can be tipped over if put on a table or counter.
Always check water temperature before bathing your baby. You may want to consider lowering your hot water heater temperature to 120 degrees for safety.
Routines
Sleeping: If discussed with your doctor, try to encourage your baby to sleep for longer periods at night and shorten the intervals during the day. More information on sleeping suggestions.
Feeding: If discussed with your doctor, try to get your baby to be an efficient and strong feeder during the day by keeping him or her "on task". At night, see if you can try to "get by" with as little as the baby needs. More information on breast feeding.
Rhythms/Cycles: The best rhythm to get your baby on is to have her eat soon after waking, stay up for a while (if possible), then go to sleep by herself; in other words - try to not feed her to sleep.
Stimulation: Try to tone down some of the daytime stimulation for your baby the first few weeks and as he or she begins to be more wakeful during the day, you can begin to increase the daytime stimulation.
Infant Development
Don't forget to give your baby lots of supervised "Tummy Time". This only has to be for a short time, but you should do this several times a day.
Babies can not see color at this time, they prefer to see sharp contrast items. If you have any black and white picture cards or rattles, hold them about 12-14 inches away from your baby for sharpest focus. You may also go to the following website and print some patterns from your computer:
http://baby.zorger.com/baby.zorger.com.newborn.pdf
or
http://babystrology.com/baby-learning/infant-visual-stimulation/infant_visual_stimulation.pdf