The physicians of Laurelwood Pediatrics welcome your new baby. We are happy that you have chosen us to provide medical care and assistance to you and your newest family member. To help you get started, we have provided information on this page that will answer many of your questions and help you as you start caring for a baby in your home. You may find that referring back here will help as questions arise, but feel free to keep a list of questions as they arise so that you may discuss them with us during your regular visits. As always, you may call our office 24 hours a day for help should an emergency arise. We are here to serve you and are happy to help in any way that we can as you adjust to having a new baby in your family. Please do not hesitate to provide us with feedback as well. We welcome your suggestions and comments.
At Laurelwood Pediatrics we want to provide each of “our” children with the most advanced medical care and to treat each child as a unique individual, with sensitivity to his or her stage of physical and emotional development, and with consideration for the family and surrounding environment. We understand that the development of a child from newborn to young adulthood is a dynamic process with complex and often rapid changes. We also understand that a child’s physical health can be intricately affected by his or her environment – the family, the home, the school, and the community. Additionally, medical practice itself is a dynamic process, with continual scientific and clinical advancement. The Laurelwood pediatricians are committed to keeping abreast of the most current medical practice in order to provide all Laurelwood families the best possible pediatric care.
Other Links You Should Review
In addition to this page, make sure that you check out these links on our site:
- Location and Hours
- Questions and Answers
- Office Forms (Please note the Information & Authorization form and the Initial Health Questionnaire)
Taking Your Baby Home
Car Safety Seat
Do not take your baby home unless he/she is secured in a safety seat. Restraint devices are required by law.
Position: Your baby should be placed in a rear-facing car seat until he is 20 pounds AND is one year of age or older. The center of the back seat is the safest location for your baby’s car seat. Never put your baby in the front seat so that the baby won’t be hurt by an air bag and you won’t be distracted while driving.
Installation: Fasten the baby’s carseat firmly in the car so it is level and doesn’t slide from side to side. Remember to hold on to the car seat instructions – you’ll need them later to adjust the seat as the baby grows. (Sending in the registration card for your car seat ensures that you will be notified in case of a recall.)
Safe and Snug: To keep your baby’s head from falling forward, use a special U-shaped pillow or put rolled towels around his head. Set the shoulder straps at the lowest slot. Put the straps over the shoulders, adjusting the harness so one finger fits between the baby’s chest and the strap. The chest clip should be even with the baby’s armpits.
Inspection: Check the National Highway Traffic Safety Administration (NHTSA) website at http://www.nhtsa.gov/Safety/CPS for inspection tips and local child-seat inspection stations.
Visitors and Going Out
When babies go home from the hospital nursery, everyone wants to see them. A new baby generally gets lots of callers. For a few weeks, limit your baby’s visitors, especially children. The baby needs a little time to build resistance to common infections. You don’t know who might have a sore throat, cough or other infectious condition. It is a good idea to keep the baby out of large crowds for a few weeks (we recommend for the first eight weeks).
Caring for Your Newborn
For the first few days after your baby comes home, bath time can consist of a gentle once over with a soft, warm damp wash cloth and a mild soap. Regular baths should wait until what is left of the umbilical cord has come off and in the case of boys, until the circumcision heals. Once your baby is ready for full-fledge baths, be sure the room is warm, with no drafts, and the water is about 85 degrees. When you stick your elbow in the water, it should feel warmer than your skin, but not actually hot.
Your baby will find bath time a highlight of the day if you take a few precautions to keep soap out of his eyes and mouth and make him
comfortable. Wash your baby’s face with plain water, a soft cloth and mild soap. Wash your baby’s head gently, working front to back to keep the soap out of his eyes.
To clean the area around the eyes, use cotton dipped in cool, clear water. Clean only the outer areas of the nose and ear, using a moist wash cloth or cotton ball dipped in water. With a cotton ball, wipe away any yellowed-orange earwax that has collected in the visible part of the ear. It is important not to poke inside the ear; it is risky for your baby, painful and unnecessary. Excessive nasal secretions should be cleared with gentle aspiration by using a rubber ear bulb syringe. Don’t try to clean any areas inside the mouth until the baby starts getting teeth. Then you can teach him/her how to use a toothbrush. Powders and oils are not necessary.
Wash your baby’s hair once or twice weekly with a special baby shampoo that doesn’t sting the eyes. Don’t be concerned about hurting the anterior fontanel (soft spot). It is well protected.
It is normal for newborns to have white dandruff-like flakes on their scalps. The flakes are old skin being shed and is not a dry scalp condition. Do not use oils, lotions, or Vaseline. This will only paste the flakes to the scalp and make the condition worse. Thick, yellowish scales are called cradle cap, a very common condition in infants. It, too, is associated with old, dead skin, and is only made worse by oils and lotions. You can treat cradle cap by removing scales with a soft brush and washing with a dandruff shampoo a few times a week.
Your baby’s umbilical cord will fall off by itself in 1 to 4 weeks. Until it does, apply alcohol on a cotton swab to the cord two to three times a day. Pull the skin away from the umbilical cord so the alcohol gets into the base of the cord. If you note large amounts of a yellowish discharge or bleeding, or if the skin around the cord is red and the baby has a fever, call the office. A scanty spotting of blood from the navel just before and for a few days after the cord comes off is expected.
Circumcision is a common operation in which the foreskin of the penis is removed. Each time you change your babys’ diaper, apply Neosporin Ointment or Vaseline until the area is healed. Healing will take about 7-10 days. Report any increased drainage, redness, swelling, bleeding, or foul odor to the office. Usually after the circumcision has healed, the penis requires no additional care. Occasionally a small piece of foreskin remains. This should be pulled back gently each time the child is bathed to prevent formation of adhesions. The groove around the head of the penis should be cleaned.
Care of the Uncircumcised Penis
In the first few months, the baby’s uncircumcised penis should be cleaned with soap and water along with the rest of the diaper area. Initially, the foreskin is attached to the head of the penis by tissue, and you shouldn’t try to retract it. Your doctor will tell you when the foreskin has separated and can be retracted safely. This will not be for several months to years. After the separation occurs, you should retract the foreskin to cleanse underneath the end of the penis.
Fingernails and Toenails
Cut the toenails straight across to prevent ingrown toenails, but round off the corners of the fingernails to prevent unintentional scratches to your baby and others. Trim them weekly after a bath when the nails are softened. Use clippers or special baby scissors. This job usually takes two people unless you do it while your child is asleep.
Diapering Your Newborn
Changing your baby’s diaper frequently will keep him comfortable and help avoid rashes. Until your baby’s umbilical cord stump falls off, buy diapers with the cord area cut out or fold down the diaper to leave the area open. Before diapering, make sure you have all your supplies within reach. Wash your hands before and after changing your baby.
Setting up: Position the baby on the floor, bed, or changing table with cloth underneath. Always keep a hand on the baby, never leaving, even for a second.
Cleaning: Open the diaper. Since a newborn’s skin can be sensitive you may want to wipe with cotton balls or wash cloths and warm water. Switch to disposable wet wipes at about two weeks.
Wiping for Girls: Wipe from front to back to reduce the chance of spreading infection from stools.
Wiping for Boys: Be sure to clean in between all crevices. Be gentle around the circumcision. Protect yourself from an unwelcome squirt by placing a soft cloth over the penis while changing the diaper.
Putting on a New Diaper: Lift both legs up at the ankles to wipe underneath and slip in a new diaper. Let the legs down gently. Fasten the diaper snugly but not too tight.
Some babies are more prone to diaper rash than others. Almost all babies will have diaper rash at some time. Diaper rashes in infants under the age of 2 months should be seen and evaluated for yeast or bacterial infection.
To treat your baby’s diaper rash:
- Change diapers often. Keeping the area clean and dry allows it to heal.
- Expose the baby’s bottom to air several times a day.
- Avoid plastic pants if you use them with cloth diapers.
- At night, use disposable diapers that pull moisture into the diaper and away from the skin.
- Wash baby’s bottom with warm tap water if diapers contain only urine. Use a mild soap if there was a stool. Rinse thoroughly and pat dry.
- If your baby’s bottom is very raw, soak him/her in a tub of lukewarm water three times daily.
- A moisture repelling ointment, such as A&D Ointment, Destin or Zinc Oxide may be applied.
- Call the office if a diaper rash lasts more than 3 days or if the rash spreads beyond the diaper area. You should also call if any blisters, pimples, boils, pus, or yellow crust form on the baby’s buttocks.
Your baby’s first few stools will probably be quite dark and sticky with a substance called meconium. After a few days, your breastfed baby’s stools will be a seedy mustard color, probably quite soft and watery. This occurs because breast milk is easily digested and doe not mean that your baby has diarrhea.
For the first six weeks, your baby will have frequent bowel movements. After six weeks, they are less frequent. Your baby’s stools will probably change in color and softness over time as well. Each baby’s stool pattern is different. Your baby may have a stool after each feeding or may not have a stool for several days. As long as your baby seems happy and content, is eating normally, and has no signs of illness, don’t worry about minor changes in stools. If your baby strains, turns red in the face, grunts, or cries when having a stool, don’t worry. This is normal as long as the stool is soft.
Feeding Your Newborn
Initially most newborns have little appetite. They were well nourished prior to delivery and are born with a small amount of extra fluid in their bodies which helps them tolerate smaller fluid intake during the first few days. Most babies normally lose up to 10% of their birth weight (or 4-10 ounces) in the first week. This is no cause for concern. It is all part of your baby’s adjustment to the outside world, and most of the weight loss is water. By 10 days of age, most babies gain back what they lost. Do not be too concerned if there is seeming lack of interest in feeding for the first few days.
Babies differ in their feeding needs and preferences, but most breast-fed babies need to be fed every 2 to 3 hours and nurse 10 to 20 minutes on each breast. Formula-fed babies usually feed every 3 to 4 hours and finish a bottle in 30 minutes or less. Bottle-fed infants drink about 2 to 3 ounces at first. By the time they are a few weeks old, their formula consumption has generally doubled. The maximum amount recommended per day is 32 ounces. Overfeeding can cause vomiting, diarrhea, or excessive weight gain.Your new baby may cry as though asking to be fed as often as every 2 hours. Keep in mind though, that babies don’t need to be fed every time they cry. When a baby cries for a short time on a regular basis, he/she may just need more milk at each feeding. Or he/she may be protesting that his/her diaper is wet or that he/she is hot. It is best not to get into the habit of offering frequent small feedings to please a fussy baby. So before you offer the breast or bottle, be sure your baby is not crying for some reason unrelated to hunger.
Your baby should not be allowed to sleep more than 4 hours during the day without feeding. Otherwise, there is a risk that the baby will reverse day and night and feed at night rather than during the day. Make nighttime feedings brief and boring. Feed quickly and quietly and don’t stimulate the baby.
How Much Is Enough?
The best gauge of good nourishment is growth. This is measured by weight and length. During regular check-ups your baby will be weighed and measured. Breast-fed babies may lose a little more weight. Healthy, well-fed babies usually double their birth weight by 5 months and triple it by one year.
Signs of a well-fed baby:
- Looks and acts satisfied after feedings
- Wets six or more diapers daily (after 4-5 days of age)
- Has yellow stools or frequent dark stools (after 4-5 days of age)
Babies do not routinely need extra water. Until 4 months, the formula or breast milk will meet your baby’s fluid requirements. Water need not be sterilized unless it is “well” water.No Cow’s Milk! Cow’s milk in any form, whole, 2 percent, or skim, should not be given until your baby is one year old. Cow’s milk doesn’t supply the balanced nutrition your baby needs, and it is often hard on babies’ sensitive digestive systems. Solid foods should not be started until the fourth to sixth month.
How to Feed
You should sit upright in a comfortable chair and hold the baby in your arms in a semi-upright position to feed. When the baby appears to be satisfied, put him/her on your shoulder and gently pat his/her back just below the shoulder blades until he/she burps. Then offer feeding again. This should be repeated as often as necessary through the meal until the baby is full and will take no more, usually after 2-3 oz. of formula or after 5-10 minutes nursing. Your baby may spit up small amounts of formula or breast milk. Don’t be alarmed. This happens to all babies. You may be able to reduce the spitting up by burping your baby more often or longer during and after feedings.
Mealtime is more than an opportunity to get nutrients into your baby. It is a time for closeness and sharing. Your baby’s meals are as much for emotional pleasure as physical well-being. Maintain eye contact with your baby while you feed him/ her. Hold him/her comfortably close to you and talk to him/her softly during the feeding.
Babies who are breastfed have fewer infections and allergies during the first year of life than babies who are fed formula. Breast milk is also inexpensive and served at the perfect temperature. Breastfeeding become especially convenient when a mother is traveling with her baby. Overall, breast milk is nature’s best food for young babies. The first few days of nursing will be a time of learning for you and your baby. Neither of you may accomplish a lot on your first few tries. A clear or yellowish fluid called colostrum that is extra rich in nutrients will come from your breasts. Although the amount will be small, it is close to what your newborn’s stomach can hold. At first your baby will nurse often, eight or more times in 24 hours.
To begin breastfeeding, rinse your nipples with plain water, and then dry them gently. Cup your breast with thumb on top and forefinger underneath. Lightly touch your baby’s lower lip with your nipple. Wait until your baby opens her mouth wide – like a yawn – then draw her in close (rather than leaning in to her). Check that your baby is latched on correctly. If her mouth is opened wide enough when you draw her in, her lower lip will curl down to ensure that she latches on correctly. She should have her mouth around the nipple and as much of the areola as possible. Once she is latched on, you should hear her sucking, usually several sucks, then a pause and a swallow.
To release your baby from the breast, break the suction by pushing in on your breast or gently placing your finger between her gums.
Nurse from both breasts at each feeding. As long as you are holding your baby in the correct position and nursing is comfortable, there is no need to limit the time your baby nurses at each breast. Generally 20 minutes of breastfeeding is sufficient. It’s common to need to stimulate your baby before she will take the second breast.
If you have trouble with sore nipples, make sure that your baby has latched on correctly. Also, start nursing on the side that bothers you least.
If you need to skip any feedings due to sore breasts, express your milk by hand or with a pump at the baby’s regular feeding times so you’ll maintain your milk supply.
Expressing Breast milk
By expressing and storing your breast milk, you can make it available to your baby at any time. This may be done by hand or by using a breast pump.
To express by hand:
- Wash your hands with soap and water.
- Place a clean cup under your breast (in your lap or on a table).
- Put both hands on your breast, thumbs on top and fingers cupped around and under your breast.
- Gently move your hands toward your nipple. When you are near your areola, release one hand. (This will be your free hand.)
- With your free hand, grasp your areola between your thumb and first finger.
- With the hand still around your breast, gently roll your thumb and finger toward your nipple, lightly pressing them together.
- Rotate the thumb and finger of your free hand to a different position on your areola and repeat. This helps to get milk from several positions.
It may take a few minutes for your milk to start coming, but this will get easier after you have breastfed for a while.
Storing Expressed Milk
To prevent contamination and bacterial growth, properly store your breast milk:
- In disposable bags designed for breast milk, plastic bottles, or glass bottles
- No more than two to three hours at room temperature, although immediate refrigeration is recommended
- Up to 48 hours in refrigerator or three to six months (in a plastic bottle or disposable bag designed for breast milk) in rear of the freezer compartment, according to the American Academy of Pediatrics (AAP)
- Use fresh or frozen breast milk as soon as possible as antioxidant levels in breast milk are unstable and will decline in stored breast milk over time.
To thaw frozen breast milk, place the storage bag or bottle in a bowl of warm water or hold it under warm running water. Never defrost or warm breast milk in a microwave oven; it can destroy delicate nutrients.
Mothers with colds or minor illnesses may continue to breastfeed their babies. Medications taken by a mother can pass into her breast milk. Examples are sedatives, tranquilizing agents, mood-altering drugs, laxatives, and antibiotics. If you are breastfeeding, please check with our office before taking any medications.
During lactation, your body used nutrients to make breast milk first before using them for your body. A healthy diet is as important now as when you were pregnant because it must sustain both your baby’s rapid growth and your own health. Both of you need strong bones, energy, and plenty of fluids.
As a nursing mother, you will need to eat a balanced diet that contains 500 more calories per day than the diet you needed before pregnancy. Your daily food intake should contain foods high in protein, such as lean meats, fish, poultry and legumes. Calcium is one of the most important things you need in your diet when you are breastfeeding. Skim or low-fat milk, yogurt, cheese, and soy products with added calcium are good sources. If you are unable to drink milk or eat high-calcium foods, ask your doctor to recommend a calcium supplement. Fruits and vegetables are also important because they provide many of the vitamins and minerals you and your baby need. Plan to drink at least 8 cups of water each day and limit caffeinated drinks.
Foods in your diet rarely have a disturbing effect on the baby. Certain foods such as tomatoes,onions, garlic, broccoli, cabbage, chocolate and spicy foods can cause loose stools, colic, or excess gas. If your baby has any of these symptoms, review your diet for the previous 24 hours and eliminate foods on the above list and see if it helps.
Common Breastfeeding Issues
Although breastfeeding is nature’s way of providing the best nutrition for your baby, it is normal to have questions or setbacks along the way. Here are a few tips on handling some of the most common difficulties of breastfeeding.
Leaking Milk: It is a normal physical reaction for your breasts to leak when it is about time to nurse your baby or when she starts to cry. Use an absorbent nursing pad or clean folded handkerchief inside your bra to catch the drip and change it often.
Sore Nipples: Sore and cracked nipples can result from vigorous sucking or improper latching on. to help your nipples heal, continue breast-feeding but try a new position. Allow your nipples to air-dry after you shower or feed your baby. Rub your colostrum or breast milk around your nipples. Wear cotton clothing next to your breast (a nursing bra or a loose-fitting top). Remove plastic liners from your bra.
Breast Pain: You may experience some tingling as your breasts adjust to breastfeeding. If you do have pain after you and your baby are well-adjusted to breastfeeding, it is a warning sign to heed. If pain only occurs when your baby starts nursing, it can be a normal sign of your body releasing milk. Use warm or cold compress on your breasts between feedings. Call your doctor if your temperature is over 100 degrees Fahrenheit or if one area of your breast is sore and hot. You may have a breast infection.
Slow Milk-Ejection Reflex: Sucking stimulates your body to let-down (release) milk from your breasts. To each let-down during your first
days of breastfeeding, gently massage your breast with your hand before putting your baby to the breast. Keep a positive attitude about breast-feeding and encourage the support of other family members. Breastfeed your baby in a calm, stress-free environment and stay
Difficulty Latching On: If your baby takes only your nipple and not your areola into her mouth, she may not be properly latched on and will not effectively nurse. Try breastfeeding your baby in different positions. Make sure your baby takes in enough of your breast into her mouth.
Plugged Ducts: A small, hard lump in your breast usually indicates a plugged duct. It may disappear on its own after several days. Nurse from that breast first and encourage your baby to nurse longer at that breast. Massage the area between feedings. Apply a warm, wet cloth to the area before nursing.
Engorged Breasts: Painful, hard, and swollen breasts result from the accumulation of milk. This occurs most commonly as your milk comes in, before you both have adjusted to the volume of milk your baby needs. To ease the discomfort, feed your baby more often. Try a new feeding position. Express a little milk by hand or with a breast pump if your breast is too full for your baby to latch on. Using cloth-covered cold packs between feedings to reduce swelling.
If you are having trouble breastfeeding and would like assistance, please call our office for references and additional suggest.
If you are bottle-feeding your baby, instant formula should be the only form of milk your baby gets during the first year of life. If you are using concentrate or powder, you will need to dilute with water. It is not necessary to sterilize the water unless it is well water. Be careful about keeping formula containers, bottles, nipples, and utensils free of germs. Everything should be washed thoroughly in hot soapy water and rinsed with plain hot water. You should wash your hands well with soap and water before beginning formula preparation.
There are three forms of formula available: powder, ready-to-feed, and concentrate. Each form has different requirements for preparation and handling, so choose the one that is most convenient for you.
Wash your hands with soap and water and work in a clean area. Use sterile bottles, nipples, and preparation utensils. Check the “use by” date on the can for freshness and clean the lid before opening. Always follow preparation instructions on the can, and never dilute formula with more water than instructions indicate. If your baby doesn’t finish all the formula in a feeding, discard what is left in the bottle. Never freeze formula cans or prepared formula. To keep prepared bottles fresh when traveling, store in an insulated cooler with an ice pack.
Powder is the most common and economical type of formula. When preparing it, fill the bottle with water (it is not necessary to sterilize the water unless it is water from a well) before adding the powder. Use one unpacked, level scoop of powder for every two ounces of water. Cap the bottle and shake well to mix. Store canisters of powder in a cool, dry place, avoiding excessive heat or cold. Once opened, a canister has a 30-day shelf life, making it ideal for supplementing breast milk for when traveling. Once the formula is mixed with water, use it immediately, or store in the refrigerator for no longer than 24 hours.
This kind of formula makes feeding simple. Before opening, clean the top of the can and shake it until you no longer hear the liquid inside. Pour the formula directly into a sterilized bottle, and it is ready to use. Store unopened cans in a cool, dry place, avoiding
excessive heat or cold. You can keep an opened can with the top covered in the refrigerator for up to 48 hours. Don’t store formula in a
separate container. Use a prepared bottle of ready-to-feed formula immediately, or store in the refrigerator for no longer than 24 hours.
Concentrate formula is easy to prepare. Before opening, clean the top of the can and shake it until you no longer hear the liquid inside. To prepare, mix an equal amount of water and liquid concentrate in a sterilized bottle. Store unopened cans in a cool, dry place, avoiding
excessive heat or cold. You can keep an opened can with the top covered in the refrigerator for up to 48 hours. Don’t store the formula
in a separate container. Used mixed formula immediately, or store in the refrigerator for no longer than 24 hours.
Warming a Bottle
Never heat a bottle of breast milk or formula in the microwave. It creates hot spots in the liquid that can burn your baby, and it destroys breast milk’s delicate nutrients. Instead, a bowl of water on the stove or in the microwave. Place a filled bottle in the bowl of warmed water, and let it stand a few minutes. Shake the bottle to distribute the warmed milk. Drop a bit of breast milk or formula from the bottle on your wrist. It should feel barely warm.
Many parents are proud of the day their baby begins to take solid food. They view it as an accomplishment. As a result, many babies are started on solid foods before their digestive systems are really ready. From a nutritional standpoint, solid foods are not necessary during the first 4 to 6 months of life. Breast milk or full-year formula provides all the nutrients a baby needs. If you introduce solid foods too early, your baby is more likely to have allergic reactions. Babies can’t properly swallow solid foods, before four to six months of age. And your baby’s digestive system must mature somewhat before it can handle these new foods.
Your physician will discuss with you the best time to introduce solid foods. Before you introduce solid foods, ask yourself these questions:
- Has your baby doubled his birth weight?
- Does he consume 32 ounces or more of breast milk or formula each day?
- Can he move a dab of thinned baby cereal to the back of his tongue and swallow it? This is a signal that the baby’s extrusion reflex has disappeared and he now has the ability to swallow non-liquid foods.
- Does he frequently put things in his mouth?
If you can answer yes to these questions, he may be ready to start solid foods, but it is important to consult your baby’s doctor first. Remember, until your baby is about a year old, his main source of nutrition should still be breast milk or iron-fortified formula.
The American Academy of Pediatrics (AAP) recommends that rice cereal be your baby’s first solid food. Iron-fortified rice cereal is often recommended because it is easy to digest and unlikely to cause allergies. Mix about one teaspoon of cereal with three to four teaspoons of water, breast milk, or iron-fortified formula. The cereal should be slightly thicker than breast milk. When you baby eats a total of about six tablespoons of rice cereal a day, it’s time to introduce another cereal (such as oat or barley). Before long your baby will be ready for pureed vegetables and then fruit. Allow at least 5 days after each new food before introducing another so that you can pinpoint the cause of any allergies or other problems if they occur.
When your baby is about nine months old and has developed front teeth, you may introduce finely chopped cooked meats (tender cuts of chicken, turkey, beef, lamb, and pork).
New foods should be introduced one at a time. When a new food is introduced, no other new foods should be given over the next week.
Unless instructed by your physician, you should not change formulas at the same time you are introducing new solid foods. If the food causes diarrhea, constipation, or a rash, you should stop giving the particular food. By introducing new foods slowly, you give your baby’s system a chance to adjust, and it is easier to trace problems back to the source. If a particular food does not agree with your baby, try it again when the baby is older.
Foods to Avoid
Certain foods should be avoided until after the first birthday.
- Cow’s milk, which is too concentrated for your baby’s system and may cause symptoms of intolerance and does not contain sufficient iron for your developing baby.
- Salty foods, since your baby wasn’t born with a taste for salt.
- Honey, which can contain spores that cause infant botulism poisoning.
- Nuts, grapes, whole raw vegetables, small candies or suckers, hot dogs, raisins, popcorn, or chunks of meat which can cause choking.
- If there is a history of food allergy in your family, avoid introduction to those foods until 2 years of age.
A true allergy to a particular food is not very common in infants, and can be controlled by changing the formula or diet. The best way to help your baby avoid allergies is to breastfeed. Occasionally, a formula-fed baby may develop symptoms that might indicate an allergy such as colic, severe rash (especially around the mouth or diaper area),eczema, bloating, gas, vomiting, or diarrhea that won’t clear up. If there is a history of allergy in your family, these symptoms are even more likely to indicate an allergy. Please alert your physician if allergies run in your family.
During the first 10 to 14 days, most newborns will sleep more than they do anything else (as much as 18 to 22 hours a day). Some babies, on the other hand, are awake for longer periods of time with no apparent problems. In either case, it is best to allow your child to determine the amount of sleep wanted and needed. The American Academy of Pediatrics (AAP) now recommends that infants be placed on their backs when sleeping. This position has been shown to reduce the risks of SIDS (Sudden Infant Death Syndrome) in infants. Never use a pillow in the infant’s bassinet or crib. A triangular wedge, sold in most stores may be used. There is evidence that pacifier use may reduce the incidence of SIDS as well.
Babies generally start sleeping through the night around 1 to 2 months of age or when they have reached about 12 pounds in weight. Some babies start sooner. You may have heard that starting solid food will make a baby sleep through the night. There is no evidence that this is true. The key is to teach your baby to fall asleep on her own.
Most babies start teething at 6 to 7 months. A few begin at 3 to 4 months, but others may not start teething until later. Most babies are
not troubled by the teething process. But others get irritable, eat poorly, and have trouble sleeping while teething. Some infants have low-grade temperature but not over 100.5 rectally. Teething toys and teething biscuits are helpful while teeth are coming in.
Ways that tiny babies can communicate are limited. Crying is one of them. Crying is how your baby makes his/her needs known and displeasure felt. As you’ll soon find out if this is your first baby, most parents quickly learn to identify whether their baby is crying from hunger, restlessness, pain, anger, or some other reason. Many babies go through unexplainable fussy periods each day as they adjust to living in the world. Don’t worry about spoiling a tiny baby by pampering. He/she needs to know you are there to meet his/her needs.
There are a number of things you can do to comfort your baby, such as:
- Give the baby something to suck, such as a pacifier.
- Lengthen feeding times.
- Give the baby more physical contact and movement, walk, rock, or pat him/her.
- Take the baby for a stroller ride or a car ride.
- Bundle the baby snugly in a blanket.
- Check the temperature of the room if you think the baby is too cool or too hot.
- Move him/her from his/her back to his/her stomach or vice-versa.
- If all else fails, just let him/her cry. He/she may need to let off steam and often will fall asleep after a good cry.
Siblings and Pets
A new baby in the family can be a stressful event for the older children. To ease the stress as much as possible, have your older children visit you and the baby in the hospital. Talk with the older children on the phone while you area in the hospital. When you arrive home, have someone else carry the baby inside. This allows you to be free to greet your other children. The new baby will be receiving many gifts. Have gifts for the older children at times. Let the older children help you with the baby as they would like, but don’t force the interaction. Reinforce the older children’s position and importance in the family by setting aside time to spend with them that is not interrupted by the baby. If you have rivalry problems, please feel free to discuss them with your physician.
If you have pets, never leave your pet and the baby alone in the same room. This includes situations where your pet may be able to get your baby without your knowledge. This is for the safety of both your baby and your pet. Regardless of the temperament of your pet, he may become jealous just as an older child might.
Below are some warning signs of severe illness. If your infant has one or more of these symptoms, its does not necessarily mean severe illness is present. However, it could be; therefore, please call the office if you note any of the following:
- Temperature of 100.5F rectal in any baby less than three months of age; temperature greater than 101∞F (rectal) for more than 24-28 hours in an older baby
- Vomiting, not spitting up
- Refusal to take feedings
- No energy
- Diarrhea, especially if there is mucus, blood, or an unusually bad smell
- Hard crying with no obvious cause
- Inability to see or hear normally
- Unusual rash
If your child is 3 months or younger and has a rectal temperature of 100.5 F or higher, call the pediatrician immediately (day or night).
You may need to notify the doctor if your child is between 3 to 6 months and has a temperature greater than 101 F or is older than 6 months and has a temperature greater than 103 F. An elevated temperature indicates an infection in the body. The infection may require antibiotics for treatment. In many cases involving an older infant, the decision to all the pediatrician will depend upon the symptoms accompanying the fever such as earache, cough, and runny nose. If your child is over one year of age, is eating and sleeping well and has playful moments, there is usually no need to call the doctor immediately. Your child may have a virus. You may wait to see if the fever resolves on its own after 24 to 48 hours. If the fever persists longer, it is appropriate to all the office.
The simplest and most accurate way to take a baby’s temperature is rectally. First, lubricate the bulb of the thermometer with petroleum jelly. Place the baby on his/her tummy. With your thumb and index finger, spread the baby’s buttocks and insert the tip of the thermometer with your free hand. Remove the thermometer after 1 minute. There is often confusion about adding a degree, depending on the way the temperature was measured. It is much less confusing if you refer to a temperature with the actual reading and the way it was measured. For example, “101 degrees F, under the arm.”
If your older baby has a temperature, give him extra liquids such as water and juice. If the fever is very high, sponge the baby off with water that is at room temperature or give him/her a bath in water this temperature for 20 to 30 minutes. Don’t make the water too cold or too hot. This can give the baby chills. Do not use plain alcohol either. It can be absorbed by the body. Fever medications may be helpful, and may be recommended by your doctor. If your baby is younger than 3 months, please do not give anything including fever medicine before calling the doctor.
If the baby has forceful, persistent vomiting at any time in the first 6 months, call the office. Persistent vomiting with fever or abdominal
pain needs prompt attention. If you baby bumps his/her head hard, falls headfirst, or is struck in the head and later starts vomiting, call the office first.
A baby has diarrhea when he/she passes frequent, loose, or watery stools. Usually diarrhea is not a medical emergency, but it can lead to dehydration, which is a serious complication. Dehydration is caused when minerals and fluids are lost in diarrhea. Dehydration can be prevented by giving your baby the right fluids when he get diarrhea.
Not every clear liquid has the right amounts of minerals, salts, or carbohydrates your baby needs when he/she has diarrhea. A commercial oral electrolyte solution such as Pedialyte is recommended. This has the proper balance of minerals, salts, and carbohydrates. These solutions can be found in most drug stores and some grocery stores. It is a good idea to have a bottle on hand, just in case.
When your baby has diarrhea, you should call the office if you notice any of the following:
- Mild diarrhea that lasts more than 2-3 days
- Severe diarrhea (6-8 stools in 6-8 hours)
- Fever above 100.5∞F rectally that lasts longer than 24-48 hours
- Vomiting 2-3 times in a 2-3 hour period
- Vomiting for more than 24-48 hours
- Blood in the stool
- Infrequent wet diapers (further apart than every 2-3 hours)
- Deeply colored urine
- Lethargy or excessive sleepiness
- Acting very sick
If the skin of your baby’s buttocks gets red or sore from the diarrhea, especially the area around the anus, wash it after each bowel movement. Then apply a thick layer of petroleum jelly. Change diapers immediately after each bowel movement.
Most diarrhea is caused by intestinal viruses and is very contagious. Wash your hands well after diaper changing or using the toilet to prevent the virus from spreading to other family members.
Colic is limited to newborn infants and the cause is usually unknown. Colic usually clears up before the third or fourth month of life.
The infant with colic may have cramping abdominal pain and may cry for long periods of time, usually starting in the early evening. He will draw up his/her legs, chew on his/her fist, and act hungry. Do not feed an infant with colic more than every 3 hours, as this
will make the colic worse. There is no cure for colic; it must run its course. Medication or change in feeding may be suggested by your physician to help your infant feel more comfortable.
Occasional colds are unavoidable in babies and children. Usually colds involve no more than a runny or stopped-up nose and mild cough can be handled at home. If your baby has vomiting or high fever along with a cold, call the office.
During the first month or two of life, most newborns have some nasal mucus that can cause sneezing and noisy breathing. Salt-water drops instilled into the nostrils may loosen congestion. Then a nasal bulb may be used to remove the secretions. A vaporizer of the cool mist type in your baby’s room might also help.
All of your family’s medications should have child proof caps. They should be kept in locked or out-of-reach cabinets. You should also store soaps, cleaning agents, and painting supplies in a secure place. It is surprising how quickly little fingers become nimble enough to open drawers and doors and pry the lid off things. If you have seen your child swallow medicine or poison, call the office or Poison Control Center 1-800-222-1222 at once.