NURSERY ROUTINES
Considering what babies go through during the birth process, they hold up amazingly well. Most babies have an initial wake period that lasts about an hour, followed by a period of four to six hours during which they sleep.
Antibiotic eye ointment is placed in all infant’s eyes at birth. Babies also receive a shot of Vitamin K to improve their blood clotting abilities.
Before discharge, your infant will have a newborn metabolic screen drawn to check for a variety of potential congenital disorders. The first hepatitis B vaccine will be given in the nursery.
NEWBORN APPEARANCE
During the first hours after birth, infants frequently have a long head as well as various bruises and marks, particularly in back of the scalp. These will improve with age and often disappear in the first day. The eyelids may be swollen shut and there may be be some bright blood spots on the whites of the eyes. These are common and almost always clear within the first month.
Babies frequently have a variety of rashes at birth and shortly thereafter. Most rashes are not serious and require no treatment. Some common rashes include Milia, Erythema Toxicum and scaly skin. Milia consists of little white pimples across the nose and face. Erythema Toxicum are red spots with yellow centers that come and go in the first week. Also common are red marks on the forehead, eyelids, and the nape of the neck. A grayish brown bruise over the lower back and buttocks is also normal and will fade with age.
BABIES ARE BABIES
Swollen eyelids, swelling of the breasts in both girls and boys, lumps on the side of the skull, blueness of the hands and feet, quivering movements of the chin, arms and legs are all common findings that are normal in a newborn.
All babies sneeze and this does not necessarily mean they are catching a cold. Babies frequently make a rattling sound as they breathe. This is usually related to mucous in the back of the nose and gradually improves with age. Newborns often have irregular breathing patterns. You may notice your baby’s breathing varies from shallow and quiet to deep and strong. This is normal.
CRYING
Crying may be baby’s way of saying “I’m hungry,” or “I’m tired,” “I’m bored,” “I’m wet,” or possibly the baby may be crying for no reason at all.
Most babies have irritable periods when they cry more than you think they should. They often pick one time of the day to be fussy for no apparent reason. Normal fussiness peaks at six weeks of age. This is the baby’s way of “letting off steam” and you do not need to worry if the baby is still eating well and not running a fever.
Put your baby to sleep safely!
Your baby should NEVER sleep on his stomach.
Your baby’s risk of Sudden Infant Death Syndrome (SIDS) is much higher any time he sleeps on his side or stomach.
A baby placed on his side can roll over on his stomach. These positions put your baby’s face in the mattress or sleeping area, which can smother him.
Babies should sleep on their backs, in their own beds (crib, bassinette, pack and play.) The mattress should be firm, with no soft objects or materials in the sleep area.
We recommend and support breast feeding as the preferred way to feed your baby. Not only do breast fed babies have less infections and better outcomes, but breast feeding is easier on both working mothers and mothers who stay home with their infants. Breastfeeding can also help to reduce the risk of SIDS.
Be prepared for some initial frustration as you begin to feed your baby in the hospital. Remember, babies are designed so that they do not have to have a successful feeding experience during the first day of life. We have gone to considerable effort to train our nurses in the teaching of breast feeding, and they will be more than happy to help you.
If you plan to bottle feed your baby and feel that breast feeding is not for you, know that we respect and support your decision. There are several commercial brands of formula available. We do recommend a formula with iron and the appropriate vitamins. Iron in the formula will not make your baby constipated.
Do not be surprised if your baby loses up to 5 to 10 percent of his weight in the nursery. This is to be expected, and we anticipate that the infant will be back up to birth weight until 2 weeks of age. Mothers who breast feed should stay hydrated. We recommend that breast feeding mothers continue on a multivitamin. Try to avoid fatigue and stress. The first day home may be accompanied by a temporary decrease in milk supply.
Once home, we recommend feeding the infant on demand. During certain parts of the day, this may be as often as every 1 ½ to 2 hours and at other times the infant may sleep as long as 6 to 7 hours. After nursing is well established you may supplement if necessary with either breast milk or iron fortified formula.
We do not require formula sterilization anymore for individuals with a city water supply. Water from a well should be boiled prior to being used to mix formula or a sterilization method should be used. The bottle of milk is customarily warmed to body temperature, although no harmful effects have been demonstrated from feeding at room temperature or even cooler. The bottle should NEVER be warmed in the microwave. This can cause the bottle to explode or scald the infant.
Never, ever, prop up the bottle and leave the baby to feed itself. The bottle can easily slip into the wrong position and cause the baby to choke and possibly die.
The amount of formula each baby takes at a feeding is variable but usually starts at 1-2 ounces and increases every week up to 4-8 oz a feed.
We will talk about sold foods at a later date, usually after 4 months of age. Beginning solid foods too soon may cause the baby to be obese or have food or skin allergies. Never put solid foods such as rice cereal in your baby’s bottle, unless advised by the doctor.
Parents usually worry that their baby’s stools are either too loose, too hard, too many or too few. Breast milk fed babies tend to have looser, more frequent stools because breast milk is so easily digested. Bottle fed babies may go five days between bowel movements. A newborn’s stools are dark green and sticky at first and in a few days become seedy and yellow-green in color. A variety of colors are okay, but there should be no blood or mucous in the stool.
Tub baths should not be given to your infant until his umbilical cord falls off. You may sponge bathe him once a day with a mild soap. Baby shampoos are also okay. We do not recommend lotions or powders and suggest you clean the diaper area with warm water. The umbilical stump may bleed. This is normal and should not cause alarm. Rubbing alcohol applied to the umbilical cord every day will help it dry up. Keep the cord exposed above the diaper so that it has a chance to dry out.
Expect some tiring, trying times as well as enjoyment in the first few weeks. Mother should plan time for herself as well as for periods of rest. We discourage visits except by close family members for the first two weeks.
New mothers need support from the father or other close relatives after birth. Your family is now restructured. Expect the possibility that fathers and other siblings may feel left out and jealous of the new infant. Mothers often feel depressed or anxious.
Most mothers find the first weeks difficult and often feel inadequate and afraid they will not succeed. This is a common feeling and is almost never warranted.
Siblings reactions can be minimized if the mother saves some special time for each sibling, apart from the new baby. Encourage siblings to also help with simple chores such as disposing of dirty diapers, or bringing a burp rag.
Every new infant is an individual. Be prepared for differences. Some infants may be very unpredictable, irregular in their feedings and difficult to console.
More babies die from accidents after one month of age than in any other manner.
Our hospital policy requires that you have an appropriate car seat before we can discharge the infant.
Crib sides should be up when the baby is left unattended. The distance between crib slats should be less than 2 3/8 inches. A can of soda should not fit through the slats. Avoid mobiles or toys with long strings, cradle gyms that are not tautly suspended and small objects in the crib.
Parents should never leave a baby alone with young siblings or pets. Water heater thermostats should be set at less than 120 degrees to avoid accidental scalding. Never leave an infant alone on a bed or other surface from which he may fall.
We strongly advise no smoking in the home. Children in families where parents smoke are more than likely to acquire upper respiratory infections and ear infections. Children can also mimic or copy the habits of their parents, leading to future bad habits.
Smoking around babies also creates an added risk for Sudden Infant Death Syndrome (SIDS), so keeping smoke away from babies is very important.
It’s difficult with newborns to decide when to call the doctor, but we would suggest you contact us when:
- The baby has a temperature higher than 100.5 F degrees before three months of age. *
- The baby refuses to eat through several feedings.
- The baby has wet burps or vomiting constantly or excessively.
- The baby is unusually irritable or lethargic especially if he or she is not feeding well.
- The baby does not look good.
*Please always take a temperature with a thermometer before calling the office to report an illness. Telling us the baby “just feels hot” is not accurate or helpful to us. Many parents don’t know how to take a baby’s temperature. Please let us know if you are unsure how to do this and we will be happy to assist you.
If you have a simple problem that you wish to discuss over the phone, your call will be referred to a nurse. If the nurse feels the doctor needs to discuss the matter with you, your phone number will be taken and the doctor will return your call at the earliest opportunity.