Newborn Well Child Check

Nutrition for a Newborn

Your baby is growing and needs only breast milk or iron-fortified formula - no cereal, baby food, juice or water is needed-for good nutrition. Breast fed babies usually eat every 2 to 3 hours, on demand. Formula-fed infants take about 1 to 2 ounces every 2 to 3 hours.

Wash bottles in the dishwasher or by hand. You do not need to sterilize bottles if you plan to feed the baby soon after filling the bottle. If your baby gets breast milk only or less than 33 oz of formula/day, they need to take 1 dropperful every day of vitamin drops such as D-Visol to prevent vitamin D deficiency. These can be purchased over the counter.

Babies often wake regularly to feed at night, but you should wake your baby every 3-4 hours at night for feedings if they do not wake on their own. Once they are gaining weight well and back to their birth weight, you can allow them to sleep longer at night. If your baby seems to be hungry all the time it may be just a need to suck. You may try a pacifier or your baby may find their thumb.

Most babies strain to pass bowel movements because of they lay down while stooling, which is naturally more difficult. As your baby’s digestive system matures, you may find that the frequency of BMs decreases. Your baby may not have a bowel movement every day. As long as the stool is soft, there is no need to worry about constipation. Babies usually wet their diaper about 6 times each day.

Development and Behavior for a Newborn

Your baby is probably sleeping most of the day and night. Remember: Babies should sleep on their backs! Remove all pillows, sleep positioners, stuffed animals, and quilted bedding from the crib to reduce the risk of suffocation.

Babies are beginning to use their eyes and ears more. They enjoy looking at brightly contrasted pictures but prefer gazing at human faces. Soft voices and music are pleasant to hear. Your baby will begin smiling at you in the next few weeks.

Your baby’s personality is starting to develop. Whether your baby is a fussy fellow or a quiet observer, crying is a form of communication and should be interpreted as your baby trying to tell you something. Colic is prolonged crying, usually at the end of the day and usually it is difficult to find out the reason for the crying. If you feel your baby is colicky please let us know!

Newborns need a lot of holding, cuddling, and talking to. They also require a great deal of your time and energy. This can be exhausting for a new parent. Help from friends and relatives is very important at this time. You are a very special person to your baby and owe it to them to take care of yourself. Rest when your baby sleeps and accept support from your family and friends.

Safety for a Newborn

In the car, always use a rear-facing car seat in the back. Wear a seat belt yourself! Never place your baby in a seat with an airbag or in the front seat. Never leave your baby alone in the car. In the home, do not leave your baby unattended, especially on an elevated surface, or with young siblings or pets. Carefully select baby-sitters and leave emergency numbers near the phone. Install smoke and carbon monoxide detectors and check batteries regularly. Set your hot water heater at less than 120 degrees to avoid splash burns. Keep your car and home smoke free.

In the baby’s room, select a crib with slats less that 2 5/8 inches apart. Keep the side rails on cribs and the mesh sides of playpens up at all times. Do not attach pacifiers or put anything around your baby’s neck.

Next Appointment

At 2 weeks, your baby will receive a checkup and be measured for height, weight and head circumference. Call our office at any time if your baby develops a fever (rectal temperature) over 100.4, has difficulty feeding, or if you have other concerns.

Helpful Tips for Taking Care of your Newborn

Breastfeeding is natural, but is not always easy! It will take a while for you and your baby to feel comfortable with this process. You will likely experience mild irritation and nipple discomfort at the beginning of each feeding until you get used to this. If the pain persists or worsens as your baby feeds, you may have cracked or blistered nipples or your baby may not be latching correctly. You may use lanolin after breastfeeding or rub some expressed breast milk onto your nipples after feeding, followed by open air to help ease discomfort. If you are experiencing extreme nipple tenderness, please discuss this with your doctor or lactation consultant.

Newborn Breastfeeding Tips

Most parents find breastfeeding difficult because they cannot tell if their baby is getting enough milk. We recommend breastfeeding at least every 2-3 hours, or more often if your baby seems hungry. You should try to keep your baby awake and sucking for 15 minutes on each breast during each feeding. During the first few weeks, it is important to wake your baby at night to feed if he is asleep more than 4-5 hours. Most would recommend waking your baby during the day if she sleeps more than 3 hours, so she can learn to eat most of her calories during the day!

Breastfeeding moms need about 500 extra calories per day. This doesn't mean you should eat whatever you want. We recommend staying well hydrated and eating a varied diet. Unless your baby seems upset by specific foods, you should be able to continue eating your favorite foods as normal. Keep in mind that any medication you take will automatically be transferred into your breast milk and to your baby, so always check with your doctor to make sure your medicines are safe for breastfeeding. We advise against drinking alcohol while breastfeeding, but if you choose to have an occasional alcoholic beverage, you should do so immediately after breastfeeding and wait at least 2 hours until feeding your baby again.

Newborn Formula Feeding Tips

Most formula fed newborns eat 1 to 2 oz every 2-3 hours. You should make sure the formula you choose is iron fortified and that you prepare it according to the package directions. Adding too much or too little water to the formula can make your baby very sick. Many preparations of formula are available including ready-to-feed, concentrate and powder. Generally parents stick with powder formulations because they are cheaper than the other options. Wash your hands well before preparing formula for your baby. Once your baby begins eating from a bottle, the formula should be discarded within one hour. It can be kept up to 2 hours once mixed if unrefrigerated and not yet eaten by baby.

Up to 10% of babies have problems with milk and soy-based formula, a condition called milk protein intolerance. Babies with this condition are very unhappy, cry often especially after feedings, spit up often, have excessive gas and may have constipation or diarrhea. They may also have blood in their stools. If you have concerns your baby may be reacting to the formula you are providing, please discuss this with your doctor!

Newborn Diaper Tips

Most babies have a wet diaper with each feeding. Immediately after birth, your baby may only have a few wet diapers each day, but this should pick up as they begin to eat well. In the first 24 hours of life, babies usually have black-tarry bowel movements containing meconium. Sometime in the first week of life, their stools will change to a yellow/seedy consistency if breastfed and more pasty if formula fed. Bowel movements can vary more between each baby - some have loose/watery stools with each feeding and others go 5-7 days without stooling. The mechanics of a bowel movement are quite difficult for infants because they stool while lying flat! Most babies grunt, strain, turn red and hold their breath while trying to stool and this is not usually a sign of constipation. Focus more on the consistency of your infant's stool and not the frequency as long as their stool is fairly soft. If your infant's stools begin to look hard like pellets, you notice blood or bowel movements are very difficult to pass, please notify your doctor.

Diaper changes can be interesting at first, especially for new parents! Unless your baby girl poops, there is no need to clean every area of her vulva with each diaper change. Try to wipe her from front to back and avoid vigorous cleaning. Vaginal discharge is usually normal unless it is yellow/green or has an odor. Bloody vaginal discharge is also a normal result of mom's hormones and usually resolves spontaneously. When cleaning your baby boy, gently clean his penis and pull back his foreskin as much as it will easily go.

Burping and spitting up sometimes occur together in infants. This can occur because the lower esophageal sphincter, or "rubber band" at the top of your infant's stomach, is not yet functioning as well as it should. This means that it is possible for contents from your infant's stomach to flow up his esophagus and into his mouth anytime he is lying flat or curled over. If your infant spits up frequently, you can position her head above her body while she is eating and try to burp her more frequently. Keep her upright for approximately 30 minutes after feeding. Some infants have excessive spit up despite their parents efforts or seem to be in significant pain during these times. If your infant develops projectile, aka "shooting across the room", vomiting or is excessively fussy with spit up, please notify your doctor.

Newborn Sleeping Tips

Sudden infant death syndrome is the sudden, unexplained death of a healthy baby during the first year of life. Always put your baby to sleep on her back - this greatly reduces her risk of SIDS. Do not allow baby to sleep in your bed. Always place her in a crib, on her back. Avoid plush bedding, stuffed animals, pillows and bumper pads.

A lot of infants reflexively wake themselves up while sleeping - the primitive reflex called the Moro or "startle" reflexes causes infants to "startle" while they are lying on their backs. If you find your infant waking up frequently when you put him down, consider the swaddle technique or "burrito wrap".

Most newborns sleep for 16+ hours per day. Sometimes they are born "confused" and don't know the difference yet between night and day. Minimize this confusion by keeping your house dark and quiet at night and avoid "tip-toeing" around your infant during the day. Your infant will not develop any nap pattern until a few months down the road, but keep in mind that most infants cannot be awake for more than 1 hour without needing to rest. If your baby is fed and changed, but still fussy - could they be tired?

It is normal for babies to cry! Most infants cry up to 2 hours per day and sometimes more as they get older. Some infants are fussy and some are laid back - just like people, they are all different! You should respond to your newborn's cries, as he is likely trying to tell you something. Responding to him quickly will help him learn that you are there to take care of him. During a "fussy" time, try to stay calm as baby will pick up on your feelings. Try swaddling your baby snugly, rocking/strolling/swinging him, playing music or turning on a form of "white noise" such as the vacuum cleaner, washing machine or fan. If you ever reach a point of frustration, don't feel guilty putting your infant in a safe place and allowing him to cry for a few minutes while you "compose" yourself. Never shake your baby! Any time your infant is persistently crying and you seem unable to calm him despite all your efforts, you should notify your doctor.

Newborn Bathing Tips

Most parents look forward to bathing their infant. Until your infant's umbilical stump falls off, you need to resort to sponge baths only. Once their stump is gone and their belly button looks normal, you can begin bathing them. Remember that infants are not "dirty," so unless there has been a diaper explosion or another event, they do not need a bath every day. There is no need to buy a special baby soap for your infant - we recommend Dove unscented sensitive bar soap as this is not expensive and is very gentle on baby's skin. You may use lotion as desired, but look for fragrance/dye-free products and do not use on baby's face or hands.

Other Newborn Tips 

Always keep infant in car seat in back seat facing backwards. Do not place in the front seat and do not place in seat with airbag.

Any time your infant is not acting normally, not feeding well or feels warm, you should always check her temperature. The best and most accurate way to do this is by taking a rectal temperature with a digital thermometer. Carefully insert the thermometer into the anus until the tip is no longer showing. If your baby has a temperature of 100.4 or higher, this is a fever and your infant needs to be checked right away. In the first 6 weeks of his life, you should take him to the emergency room at Brenner Children's Hospital for further evaluation.