Congratulations on your new baby!
If this is your first child, you probably have a lot of
questions. If you have
other children, your memories might have already faded.
Of course, friends, neighbors, and relatives are eager to
share their knowledge of baby care with you.
Just remember, what worked for them might not work for you or
your baby. I suggest
that you write down all your questions so that you remember them
when you come to the office. Anything
that concerns your desire to understand and care for your baby is
important for us to discuss.
Getting to Know Your Baby
Your baby is
a unique individual from the day he or she is born.
Most new parents are unsure of their parenting skills.
These worries will soon disappear with experience as you
provide the proper nutrition and the love, warmth, and attention
your baby needs.
sneeze, have hiccups, cry, cough, pass gas and get fussy. These are
all normal behaviors. You
will gradually learn what his or her crying indicates.
You can’t spoil your baby during the early months of life.
Regular Visits to Your
should be brought to the doctor for regular visits, even though he
or she appears well. These
visits will give me a chance to check on your babys growth and
development and to talk with you about the care of your baby.
Immunizations or shots against diseases such as whooping
cough, diphtheria, tetanus, polio, measles, mumps, rubella, and
hepatitis will be given at the appropriate times.
first medical checkup should be at 2 weeks of age unless, of course,
attention is needed sooner. Please
call the office as soon as possible to make an appointment.
always call us during office hours for any questions, advice, or
guidance that you may need. Of
course, in case of an emergency, you can have us paged anytime.
Safety Seat- These are required by law in all 50 states in the
country. They are
ranked by many consumer magazines and must conform to federal
safety regulations. While
your child weighs less than 20 pounds, the car seat face
backward. When your
child weighs more than 20 pounds, the seat can be switched to
face forward. Young
children from 40 to 80 pounds should use booster seats,
forward-facing, and belted in.
Federal safety standards require that the crib bars built after
1974 be no more than 2-3/8 inches apart.
This is so the child’s head or body cannot get stuck
between the bars. The
mattress should be the same size as the crib so the baby’s
head cannot be caught in the gap.
It should also be waterproof and covered with a soft baby
sheet. Also cover
the baby with light blankets.
Suction Bulb- This helps babies whose breathing is difficult
from sticky or dried nasal secretions.
When using this, you may first put a few drops of saline
in each nostril. Then
press the bulb before placing it in the nostril.
Once you let go, it will suction any secretions in the
A rectal thermometer is most helpful when your baby is sick.
There are digital thermometers that display the reading
in 30 seconds.
This is essential if your house has stairways that your baby
must be protected from. A gate also keeps a child in a specific room with you
and out of harms way in other rooms.
All gates should be difficult for a baby to climb.
The strongest gates are spring-loaded.
These should be used once your baby becomes mobile.
This is helpful in dry climates or areas with cold winters.
These need to be cleaned and have the water changed every
day to avoid molds and bacterial growth from building up.
Do not buy a vaporizer because the steam that it produces
could be burning.
plugs- These should be covered so that your baby can’t put his
or her fingers in it and possibly get burned.
You will be able to find plastic covers in most stores.
Walkers- This includes the walkers that are on wheels that the
baby sits in and can propel throughout a room in it.
Over 40% who use this have an accident requiring medical
attention. They get
skull fractures, concussions, dental injuries, and deep cuts.
Some parents believe walkers help children to walk.
On the contrary, walkers can delay both crawling and
new baby has not had time to build up resistance to infection, you
might want to limit visitors during the first few weeks.
Discourage handling the baby and insist on hand washing.
There will be lots of time for other friends and relatives to
visit the baby. During
the first year of life, you should try to avoid close contact with
people who have infectious illnesses.
Taking Your Baby Outdoors
You can take
your baby outdoors at any age.
Avoid crowded places for the first 2-3 months of age.
Dress the baby with as many layers of clothing as an adult
would need to stay comfortable.
In the winter, a baby needs a hat because he or she doesn’t
have enough hair to protect against heat loss.
The skin of
babies is more sensitive to the sun than older children.
Keep sun exposure to small amounts (10-15 minutes).
Protect your baby’s skin from sunburn with a hat, longer
clothing and sunscreen.
need to be held. They
need someone with a soothing voice and a soothing touch.
You can’t spoil your baby during the early months of life. Overly sensitive babies may need more attention.
Many babies go through unexplainable fussy periods each day
as they adjust to living in the world.
If all attempts fail to make your baby stop crying, he or she
may be colicky or sick, so you might need to call us.
You should never shake your baby to stop the crying.
This can cause brain damage and sometimes death.
your baby to sleep on his or her back or side.
This reduces the risk of sudden infant death syndrome. While your baby is awake and you are watching her, you may
give some tummy time by placing the baby on her tummy.
in amount, color, consistency, and frequency.
When the baby is first born, he or she will pass meconium. The bowel movement is very sticky, almost like tar and is
dark green or black in color. The
baby will have 2-3 of these and then it will change to a greener
stool, then brown and then soft and yellow. Yellowish, loose and
seedy stools are typical for breast fed infants.
Bottle-fed babies have a tendency to have stools with pastier
texture. Some babies
will go multiple times a day and others will go every few days.
As long as the stool is always soft, this is considered
normal. Also, baby’s
bowel habits can change over a period of time and still be normal.
If your baby strains, grunts or turns red in the face while
having a bowel movement, this is also considered normal.
baby’s stools are small and pebble-like, he may have constipation. Constipation has nothing to do with frequency of stools.
Don’t give him an enema, suppository, or laxative until
you’ve talked to me.
One of the
most common illnesses among infants and young children is diarrhea.
A child may have several large watery stools or more frequent
loose stools. Usually,
diarrhea lasts for a few days and can be managed at home.
During this time regular feedings, especially milk and juices
with a lot of sugar should be replaced with special fluids
containing important electrolytes in amounts similar to those lost
in stools, such as Pedialyte. But
if your baby has persistent diarrhea, vomiting and fever, or there
is blood in the stool, you need to bring the baby in to be seen.
Newborn’s Normal Appearance
Molding refers to the long, narrow, cone-shaped head that
results from passage through a tight birth canal.
The head returns to a normal shape in a few days.
Caput refers to swelling on top of the head or
throughout the scalp due to fluid squeezed into the scalp during
the birth process. This
will also clear in a few days.
Cephalohematoma is a collection of blood on the
outer surface of the skull.
It is due to friction between the infant’s skull and
the mother’s pelvic bone during the birthing process.
The lump is usually confined to one side of the head.
It usually resolves after 2-3 months. Anterior fontanel is the soft spot on the top
front part of the skull. Touching
this area softly is quite safe.
The purpose of this is to allow rapid growth of the
brain. It normally
closes between 12-18 months of age.
Subconjunctival hemorrhage is a flame shaped hemorrhage
on the white part of the eye.
It is harmless and due to birth trauma.
The blood is reabsorbed within 2 to 3 weeks.
The permanent color of the iris is often uncertain until
your baby reaches 6 months of age.
If your baby’s eye is continuously watery, he or she
might have a blocked tear duct.
More than 90% of blocked tear ducts open by the time the
child is 12 months old. You should massage the bridge of the nose toward the eye
a few times a day to help keep the duct open. Many babies look slightly cross-eyed at birth.
Usually, muscles that are temporarily out of balance
cause this. This
will correct by the end of the first year of life.
Swollen breasts are present during the first week of life in
many female and male babies.
They are caused by the passage of female hormones across
the mother’s placenta. Breasts are generally swollen for 2-4 weeks and may be
uneven in size.
The labia minora can be quite swollen in newborns because of
the passage of female hormones across the placenta.
The swelling will resolve in 2-4 weeks.
As the maternal hormones decline in the baby’s blood,
a clear or white discharge can flow from the vagina during the
latter part of the first week of life.
Occasionally the discharge will become pink or
normal discharge should not last more than 3-4 days.
The newborn scrotum can be filled with clear fluid.
This fluid is squeezed into the scrotum during the
birth process. This
is called a hydrocele.
It can take 6-12 months to clear completely.
The testicle is not in the scrotum in about 4% of
full-term newborns. Many
of these testicles gradually descend into the normal position
by one year of age.
Bones and Joints- The lower legs normally curve in because of
the cross-legged posture your baby was confined to while in the
womb. If you stand your
baby up, you will also notice that the legs are bowed.
Both of these curves are normal and will straighten out after
your child has been walking for 6-12 months.
Most hair at birth is dark.
This hair is temporary and begins to shed by 1 month of
age. The permanent
hair will appear by 6 months.
It may be an entirely different color from the newborn
hair. The permanent
hair will appear by 6 months.
Lanugo is the fine downy hair that is sometimes
present on the back and shoulders.
It is more common in premature infants.
It is rubbed off with normal friction by 2-4 weeks of
Normal Newborn Reflexes and
many harmless reflexes that are due to an immature nervous system
and will usually disappear by 3-4 months of age.
These include chin trembling, lower lip quivering, hiccups,
passing gas, sneezing, spitting up, brief stiffening of the body
after a noise or sudden movement, straining with bowel movements,
throat clearing or gurgling sounds, trembling or jitteriness during
crying, and yawning.
Newborn Skin Care
not give your baby a bath until his or her belly button cord has
fallen off (you can give sponge baths until then).
When you bathe your baby, make sure the water is
lukewarm. Use tap
water without soap or use gentle soap such as Dove.
Gently wash the baby’s face and be careful not to get
soapy water in the eyes. Do
not bathe your baby more than every other day, especially if he
or she has sensitive skin.
your baby’s hair 1-2 times per week using a baby shampoo that
doesn’t sting the eyes. If you see scales or crusting on the scalp, this might
be cradle cap. You
can put baby oil or olive oil on the hair to soften the crusts. Apply for one hour and then wash it off with an
antidandruff shampoo, such as Selsun Blue.
the outer areas of the nose and ear only, using a moist
washcloth or cotton ball dipped in water.
With a cotton ball, wipe away any yellow-orange earwax
that’s collected in the visible part of his ear.
It is important not to poke inside the ear because it is
risky, painful, and unnecessary.
umbilical cord will usually fall off in the first 2-3 weeks of
life. There is
often a discharge and even a few drops of blood.
If there is redness, bleeding, or discharge after the
cord falls off, please call us.
Do not immerse the baby in water until the cord has
your baby’s diaper frequently.
If you have a boy, gently clean his scrotum with a wet
washcloth. Do not attempt to retract the foreskin.
If you have a girl, gently clean from the front to back
and between the creases of skin around the vagina.
Never use soap to clean this area, only plain water.
Some babies are more prone to diaper rash than others,
but almost all of them get it sometime.
You should change the diaper more frequently and keep the
area dry and clean. If your baby has a rash, expose his or her bottom to air
several times a day and avoid plastic pants. Wash your baby’s bottom with warm tap water and mild
soap and then pat dry. If
your baby’s bottom is very raw, have her soak in a tub of
lukewarm water for 15 minutes three times a day.
If your baby’s diaper rash lasts more than 3 days, call
the office or come in to be seen.
Never leave the baby on the changing table unattended.
circumcision area heals in 5-7 days.
Apply a dab of Vaseline at each diaper change until it
heals. Call us if
there is any swelling or bleeding.
clippers or special baby scissors to cut your baby’s
fingernails and toenails. Trim
then once a week after a bath because this is when they are soft
and easy to cut. Cut
the toenails straight across to prevent ingrown toenails.
When you cut the fingernails, round off the corners
babies do not need lotions, creams, or powders.
You may want to use a moisturizing cream (i.e. Eucerin,
Aquaphor, Aveeno, Cetaphil) after 2 weeks of age if your
baby’s skin gets dry or cracked or if your doctor advises it.
This can be used twice a day.
Avoid talcum powder because it can cause a serious
chemical pneumonia if inhaled into the lungs.
clothing, blankets, bibs, and other items should be made of a
material such as cotton that can withstand high-temperature
laundering and sanitation to kill bacteria.
The detergent should be free of perfume and enzymes
because these agents can cause potential allergies or
irritations to the skin.
exposed to direct sunlight or even overcast midday skies should
be covered with lightweight clothing and shaded with a canopy or
hat. Regular use of
sunscreen to frequently exposed areas also is necessary.
If you think
your new baby has a fever (defined as 100.4 or greater taken
rectally), first undress him or her and let the baby sit for 10
minutes. Then take the
temperature rectally. To
take the temperature rectally, first lubricate the bulb of the
thermometer with petroleum jelly.
Then place the baby on his 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.
If the temperature is greater than 100.4 and your baby is
less than 6 weeks old, you should call us immediately.
This is considered an emergency.
If your baby is older than 6 weeks and has a fever, you can
still call us and should come in to be seen.
If the baby
does have a fever, give extra fluids.
If the fever is very high, I suggest also sponging the baby
off with water that is at room temperature.
Ice baths should never be done at home.
You may give Tylenol or acetaminophen every 4 hours as needed
for fever. Once the baby is 6 months or older, you can start giving
Motrin or ibuprofen every 6 hours as needed for fever. The dosing chart is at the end of this booklet.
Newborn Skin Rashes and
of newborn- More than 30% of newborns develop acne, mainly small
red bumps. This
begins at 3-4 weeks of age and lasts 4-6 months of age.
It is due to the transfer of maternal hormones just prior
to birth. No
treatment is necessary, as it will resolve on its own.
rash- A rash on the chin, cheeks, or neck that comes and goes is
usually caused by contact with food and acid that have been spit
up from the stomach. Rinse
your baby’s face with water after all feedings or spitting up.
toxicum- More than 50% of baby’s get this rash starting on the
second or third day of life.
The rash is composed of ½ to 1-inch size red botches
with a small white lump in the center.
They can be numerous, keep occurring, and be anywhere on
the body. It is
harmless and will disappear by 2-4 weeks of life.
This is tiny white bumps on the face, especially the nose and
cheeks. They are
blocked off skin pores and will open up and disappear by 1-2
months of age. There
is no treatment.
spots- This is a bluish-gray, flat birthmark that is found in
many babies. They
occur most commonly over the back and buttocks and vary in size
and shape. Most
fade away by 2-3 years of age.
bites- Flat pink birthmarks can occur over the bridge of the
nose, the eyelids, or the back of the neck.
Most of these spots fade and disappear, but some can
persist into adulthood.
assignments during the early months of life are feeding and loving
your baby. Feeding is
one of your baby’s most pleasant experiences.
At feeding time, your baby receives nourishment and a feeling
of security. Both you and your baby should be comfortable at feeding time.
Choose a position that will help you relax as you feed your
baby. Be sure your baby
is warm and dry.
babies weigh between 5-10 pounds.
The average is about 7 ½ pounds.
During the first days of life, infants generally lose 4-10
ounces; breast fed babies may lose a little more.
This is normal and is all part of your baby’s adjustment to
the outside world. By 10 days to 2 weeks of age, most babies gain back what they
lost. Then infants gain
approximately an ounce per day during the first few months of life. Healthy well-fed babies usually double their weight by 5
months and triple by 1 year.
is the best nourishment for your baby.
Breast milk provides just the right balance and amounts of
nutrients that babies need for good growth and development.
It also contains substances that may help protect babies
against certain illnesses and allergies.
If you choose not to breast feed or are not producing enough
milk, I would recommend any regular infant formula fortified with
iron. Milk is the only
food your baby needs in the first 4-6 months of life.
Do not switch to whole cow’s milk until after one year of
life. The also includes
cheese, yogurt, and ice cream.
The American Academy of Pediatrics advises that you keep your
baby on breast milk or formula until his or her first birthday.
schedule should be flexible, allowing your baby to eat when he or
she becomes hungry. Very
young babies usually want to be fed every 2-3 hours, but older
babies may wait for 4-5 hours between feedings.
nurse in the sitting position, hold your baby on his or her side
facing your breast, with the baby’s lower arm tucked around your
waist. Hold your breast
with your thumb above the areola (the dark skin around the nipple)
and your other fingers below. Your
baby’s face, tummy, and knees should be facing you.
Gently touch the baby’s lips with your nipple and the baby
will open his or her mouth to attach to your breast.
Make sure your nipple and the areola are in the baby’s
mouth. Pull the baby in
close to a snug tummy-to-tummy position.
If necessary, lift your breast up with your fingers to keep
it away from the baby’s nose.
breasts every time you nurse. Your
baby will empty most of the milk in your first breast after 5-10
minutes of vigorous sucking. So
nurse at least that long on both breasts to a maximum of 20 minutes
on each breast. To
change breasts, put your finger into the corner of the baby’s
mouth between the gums, and the baby will open his or her mouth.
Let your breasts completely air dry after nursing.
Start with a different breast each time.
Following breastfeeding guidelines carefully will prevent or
minimize sore nipples.
If you need
to be separated from your baby at feeding time, you can leave behind
a bottle of milk that you expressed from your breasts with a pump or
by hand. Breast milk
that is frozen remains good for 4-6 months.
It is good for 24-36 hours in the refrigerator and only good
for a few hours at room temperature.
These rules also apply to formula milk. When defrosting
frozen breast milk, use the oldest milk first and defrost it with
warm water. If breast
milk is not available, you can leave a bottle of prepared infant
As a nursing
mother, you’ll need to eat a balanced diet that contains 500-600
calories more per day than the diet you needed before pregnancy.
Your daily food intake should contain a lot of protein and at
least one quart of milk. This
will provide enough calcium for both you and your baby.
Limit beverages containing caffeine.
Avoid alcohol and omit artificial sweeteners from your diet.
Foods in mothers’ diets rarely have a disturbing effect on
their babies. It can
happen with certain foods such as tomatoes, onions, cabbage,
chocolate, and spicy foods. If
your baby has loose stools, colic or excess gas for no reason that
you can think of, review your diet and try to eliminate foods from
the above list and see if it helps.
Medications taken by a mother can pass into her breast milk.
This includes prescription and over-the-counter drugs.
Examples are sedatives taken for sleep, tranquilizing agents,
other mood-altering drugs, laxatives, and antibiotics. Coughs, colds, and the flu are not harmful to the baby and
you should continue to breastfeed.
When you are
feeding with a bottle, your baby’s head should be slightly raised
and resting in the bend of your elbow.
Hold the bottle so the nipple is always filled with formula.
This helps your baby receive formula instead of air.
Air in the baby’s stomach may give a false sense of being
full and also may cause discomfort.
Never prop a
bottle or leave your baby alone to drink.
The bottle could slip and make the baby choke.
Remember, too, your baby needs the security and pleasure of
being held at feeding time. Face-to-face
contact is very important for your baby.
Always test the temperature of the formula before giving it
to the baby. Test it by
dripping a small amount on your inner wrist.
It should feel about room temperature.
Never warm the formula in a microwave.
This can create hot spots in the bottle and burn the baby’s
mouth. Heat the formula
by putting the bottle in a pan of lukewarm water until it is at the
your baby will drink every drop of milk in the bottle, and sometimes
not. Don’t worry-
this is normal. You can
usually tell when your baby has had enough when he or she stops
sucking, frequently turns away, or falls asleep.
You should never force your baby to finish every bottle.
Throw out anything left in the bottle.
When your baby regularly finishes every bottle at each
feeding, it may be time to increase the amount of the milk in the
bottle. Do not switch
to whole, cow’s milk until your baby is one year’s old.
This includes products with cow’s milk in them, such as
cheese, yogurt, and ice cream.
should finish a bottle in 30 minutes or less.
Newborn babies usually drink 2-4 ounces at first and then
gradually increase the amount.
Do not wake up your baby for a feeding unless it has been at
least 5 hours since the last one.
Generally speaking, you should feed your baby every 2-4 hours
during the day and on demand at night.
Bottles are good for 24-36 hours after they are prepared if
stored in the refrigerator. They
are only good for a few hours if left outside.
time, wash the bottles and nipples in hot, soapy water and rinse in
plain, hot water to prevent bacteria from growing.
Sometimes, the bottles with disposable bags will save time on
cleaning. Bottles and
nipples can be washed in the dishwasher on the top rack in hot
water. Also, squeeze
water through the nipple hole to keep it from clogging.
Test nipples regularly to be sure the holes are the right
size. If the nipple holes are too small, the baby may tire of
sucking before getting all that he or she needs.
If the holes are too large, the baby will get too much and
too fast. The baby may
also get so much air that he or she spits up all or part of the
feeding. When the nipple holes are the right size, the liquid should
drip smoothly, without forming a stream.
after breastfeeding or bottle-feeding you should burp your baby to
remove swallowed air. Sometimes
a baby will not burp, so don’t try to force a burp if the first
few attempts are not successful.
Don’t be alarmed if your baby spits up a little while
burping. As long as the
baby continues to gain weight and is not bothered by it, then we
usually allow him or her to grow out of it.
You may be able to reduce the spitting up by burping your
baby more often or longer during and after feedings.
Other Feeding Types
your baby honey before his or her first birthday.
Certain bacterial spores that are sometimes found in honey
may cause a serious disease called infant botulism.
Older babies don’t get this disease, so honey is not
the American Academy of Pediatrics, there is no need to begin to
feed a baby solid foods before 4-6 months of age.
When that time is near, we will discuss with you how to add
foods into the diet. Baby
food should always be fed with a spoon.
New foods should be introduced one at a time for at least 5-7
days. If food causes
diarrhea, constipation, or a rash, you should stop giving it.
If a food doesn’t agree with your baby, try it again when
the baby is older. Your
baby does not need any water unless directed by us. Do not give more than 2-4 ounces in a day.
Water does not have any calories or nutritional value so will
only fill up your baby for no reason. You should boil plain water, cool it to room temperature, and
feed it in a bottle or you can give nursery water. Babies also do not need any juice until they are 6 months old
for the same reasons.
Other foods that should not be introduced before
one year of age include eggs, nuts, peanut butter, strawberries, and
Health information and links
Please note that immunization/vaccines are the best
protection against 15-16 preventable diseases. Recommended schedule for 0-18 years of age as per ACIP (Advisory Committee on Immunization
Practices) is available at http://www.cdc.gov/vaccines/recs/acip
American Academy of Pediatrics schedule and information may be downloaded
from the Web Site http://www.aap.org
We provide information on all vaccines as they are administered.
Influenza vaccine is recommended for all children 6 months to 18 years irrespective of underlying medical condition.
Influenza poses a serious threat for children with chronic medical conditions.
The adolescent tetanus vaccine Tdap includes protection against whooping cough/pertusses. Whooping cough can be very serious for infants.
Adults and adolescents can pass on the disease to the unprotected smallest infants. Therefore Tdap boosters are essential for
protection of entire community.
Pneumococcal disease is very serious and can be fatal.
Minectra the vaccine is given to all children above 10-11 year age and high risk children at a much earlier age.
This vaccine is designed to protect against
the major strains of the human papiloma virus (wart virus). Human papiloma virus (HPV) that causes genital warts is associated
with high risk of cervical cancer. HPV has also been associated with oral cavity cancers. At this time females 9-26 years of age
can get the vaccine in series of 3 shots. In due course of time more strains may be added and will also be available
for the male population.
Pneumococcal vaccine has significantly decreased the pneumococcal infections
from the vaccine serotypes. However, some serotypes are now emerging in greater numbers. Certain high risk patients may be given
a pneumococcal vaccine booster beyond 24 months of age.
Please refer to the following Web Sites
for more heath information:
Academy of Pediatrics(AAP)
American Academy of Allergy, Asthma, and Immunology:(AAAAI)
World Allergy Organization:
American College of Allergy Asthma and Immunology: