Education

The following information is provided to complement any advice you recieve from our office.

Caring For Your Baby - Information for New Parents

Congratulations! You are about to embark upon the very exciting time of caring for your new baby! This handout is intended to anticipate some of your questions, and impart some important information about the care of your newborn baby during the first weeks at home. It is not intended to replace the advice and care of your baby's pediatrician; you should always seek this advice if you have concerns about your child.

To reach our office for advice, emergencies, or to make an appointment, please call: (978) 927-4980.
Informational sections include: Feeding, Sleeping, Crying, Fever, Breathing, Smoking, Diapers, Bathing, Jaundice, Car Seats, Going Outside, Rashesand Doctor Visits.

Feeding

Breastfeeding provides the perfect nutrition for your baby to grow and be healthy, and provides help for your baby to fight infections. It can be a very rewarding experience, and is highly recommended by pediatricians. If you need assistance, ask someone who has breastfed successfully or a medical professional. Please call our office or the lactation consultants if you have questions. Your pediatrician can direct you to more detailed information on breastfeeding. If you choose to feed your baby with formula, the standard infant formulas with iron will also provide all the nutrients that your baby needs. Powdered forms of formula are less expensive, and may be prepared by adding tap water according to the directions on the can. Formula can be warmed by placing the bottle in a pan of warm water. Do not use a microwave for warming, as this can heat unevenly and make "hot spots" which can burn a baby's mouth.

A newborn usually eats every one and a half to three hours, but they do not follow exact schedules by the clock. When your baby makes sucking movements as if looking for food, or is crying, it may be a sign of hunger and you should try feeding. After a while you will be able to tell when your baby wants to eat. During the first days at home, your baby may be sleepy, so be sure your baby is waking for feeds at least every three hours during the first few days.

Sleeping

When you put your baby to sleep in a crib or bassinet, the safest position is on the back. Turning the head slightly to alternate positions may help to keep the head looking rounder. It is strongly recommended that babies not be left on their stomachs because of an increased risk of SIDS (Sudden Infant Death Syndrome) with this sleeping position. Your baby will probably sleep comfortably when swaddled snugly in a baby blanket. Always be sure that your baby is protected from falling off of furniture. Always put up the side rails of the crib, because even young babies can move enough to fall to the floor. Babies don't usually sleep through the night until after three months of age.

Crying

From the very start, newborns can see and hear. Young babies can distinguish faces and recognize the familiar voices of their parents. However, they are unable to clearly communicate their needs. Therefore, as you no doubt are aware, all babies cry to express themselves. Often times this crying can simply be your baby's way of asking to be held and comforted. Holding your baby and talking to your baby often calms the crying, and you can not "spoil" a newborn.

Though you will soon learn to distinguish your baby's different cries, the crying can be quite frustrating for new, concerned parents. However, it is never appropriate to hit, shake or punish your baby, as this can cause serious injuries. If you ever feel that you may not be able to control your frustration, take a breath, and ask someone for help so you can take a break. Nobody can care for a baby alone. We all need some time for ourselves, and having a responsible friend or family member look after your baby while you take a short break can be very helpful. Please tell your child's doctor if you are feeling overly stressed, or call the Parent Stress Hotline: 1-800-632-8188.

Fever

If you are ever concerned that your baby may be sick, one helpful piece of information to obtain is your baby's temperature. Though a baby can be sick without a fever, a young baby with a rectal temperature above 100.4 (38 Celsius) may have a serious infection. Therefore, you should call our office if your baby has a fever of 100.4 degrees or higher anytime during the first three months of life. The best way to take your baby's temperature is rectally. One can also check under the arm, but ear thermometers are not accurate for babies. To take a rectal temperature: place your baby on its stomach, lubricate the thermometer tip with petroleum jelly, insert the end of the thermometer about a half inch into the rectum, and read the temperature when it beeps. Cold medicines and fever reducers are not usually appropriate for very young babies. During the first six months, do not give any medicines to your baby unless you first check with our office.

Breathing

Some babies have an unusual breathing pattern which often worries new parents. They often take several small breaths in a row, and then pause, before taking a few larger breaths. This is entirely normal. They also may have very noisy breathing because of the mucous in their noses. Sometimes babies will sneeze as a reflex to clear their nasal passages. It is sometimes helpful to remove the mucous with a bulb suction. If the mucous is hard you may first moisten it with a few drops of saline (salt water). It is more important to note if the breathing seems labored, not if it sounds loud. If your baby's breathing is fast and labored, e.g. if your baby appears to be indenting under and between the ribs, then you should call our office at once.

Smoking

Cigarette smoke is very harmful to your baby. It can cause wheezing and ear infections, and has been associated with SIDS. Avoid smoking near your baby or in your home or car, and insist that other people avoid smoking around your baby as well. This will help your baby stay healthy. It can be very difficult to quit smoking, but any decrease in second-hand smoke will benefit your baby.

Diapers

After the first couple days your baby should wet at least six to eight diapers a day with urine, as a sign that your baby is getting enough to drink. If you notice a decrease in urine you should call our office. The number of stools, or bowel movements, is more variable. Many babies have bowel movements after every feed, and others only a few times per week. Both are normal patterns. The first stools are made up of a black, sticky substance called meconium. After a few days they usually become mustard-yellow colored, and appear to be loose with small yellow "seeds". Always keep a hand on your baby at the changing table as even young babies can move enough to fall onto the floor.

Bathing

Your baby's umbilical cord will fall off after one to two weeks. It doesn't require any special care, though some recommend wiping it with alcohol. Sometimes there is a dot of blood when it falls off, and this is normal. Until the cord falls off, you should wash your baby by sponge-bathing or with a washcloth; after it falls off, you can place your baby in a small bathtub or sink while bathing. A baby doesn't need a bath every day. Typically every few days is fine. Use warm water and a soft washcloth to wash your baby. Soap is not always necessary for the first few months, but a small amount of a mild unscented soap or baby shampoo may be used. Always test the water temperature with your own hand first to be sure it is not too hot. Never leave a baby alone during a bath.

Jaundice

Many babies develop a yellow coloration of their skin, called jaundice, due to an accumulation of a substance called bilirubin. Jaundice of the face and upper chest is often normal during the first several days of life, but this should start to fade after four to five days. You should call our office if the jaundice continues to worsen after this time period or if you notice the yellow coloration all the day down to your baby's belly or legs. You should also call if a jaundiced baby seems especially sleepy, is difficult to wake for feeds, or is not having wet diapers.

Car Seats

Starting with the very first trip home from the hospital, your baby should be secured in a car seat during every trip in a car. You should use the car seat even if you are just driving around the corner, and you should use it in taxicabs and airplanes as well. This will keep your baby much safer, and as your baby gets older you will find that being in a car seat prevents your child from moving around the car to distract you and promotes better sleeping during car trips. During the first year, the car seat should be faced "backwards" so that your baby is facing the rear of the car. The seat needs to be properly fastened into the car, and your baby needs to be belted snugly into the seat. The harness of the car seat should come over your baby's shoulders and buckle between the legs. Avoid placing the car seat where it can be hit by an expanding air bag. It is safest to secure your baby's seat in the rear seat of the car. Always read the instructions to be sure you are using the car seat correctly. As with all equipment for babies, it is a good idea to send in the registration card so you can be notified in case of any safety recalls.

Going Outside

You should not feel trapped inside your home with your new baby. You can have visitors, and take your baby places. Your baby can go outside for short periods, except during extremely cold or extremely hot weather. Your baby should be dressed according to the weather, usually in one layer more than you are comfortable wearing. However, you should avoid places that are crowded or are likely to have many children around, to prevent your baby from being exposed to infections in the first few months of life. If someone is sick, it is best that they not visit with your baby. Avoid visiting places that are smoke-filled. A stroller with a canopy or a wide-brimmed hat should be used to shield your baby's skin from too much sun. During the first weeks of life it is reasonable to have visitors wash their hands before handling the baby. For premature babies, you should be even more careful to avoid sick people and crowds.

Rashes

A baby's skin is very sensitive and there are many normal newborn rashes which resolve on their own and are not harmful. Common birthmarks include red discolorations over the back of the neck or eyelids, sometimes called "stork bites" and "angel kisses". Many babies develop "pimples" over the face with some redness. This newborn acne resolves in several weeks and doesn't cause scars, so no medications are needed. Many babies develop some dry skin. Soap can cause worsening dryness, so use it only sparingly. If needed, a small amount of unscented moisturizer or diaper cream may be used a couple times per day. Do not use powders such as talc, as these can be harmful if inhaled.

OVER-THE-COUNTER MEDICATIONS

Studies about over-the-counter medications have shown that they are not effective for treating cold symptoms in babies and young children. Because they do not work, and because there is potential for serious side effects, we do not recommend using these medications to treat babies or young children. Please call our office for any fever noted in the first three months of life before giving acetaminophen (Tylenol). Do not use ibuprofen (Motrin or Advil) for a baby less than six months old. Do not use OTC cold medications to treat cough and cold symptoms in children under six years old.

IMMUNIZATIONS

Immunizations are critically important for the health of your child. These shots prevent life-threatening illnesses which could otherwise cause serious harm to your baby and to others. All of the pediatricians at Garden City Pediatrics feel that routine immunization is an integral part of good medical practice. This is in accordance with recommendations by the American Academy of Pediatrics (AAP) and the Center for Disease Control and Prevention (CDC). Immunizations undergo extensive testing for safety and efficacy before they are recommended for general use. You can always discuss your questions about immunizations with your physician.

Doctor Visits

Your baby will need to have several appointments with the pediatrician during the first years of life. These visits are very important. Your baby will need to receive immunizations to protect against serious illnesses, and frequent examinations will ensure that your baby is growing and developing well. It is helpful to keep a copy of your baby's immunization record and bring this to every visit, as well as a list of any questions you may have. Your baby's doctor will tell you when the first office visit should be arranged. This usually occurs in the first week of life.