Many parents decide whether to breast or bottle-feed before their baby's birth. This is a personal decision, of course. However, breast milk is the ideal food for an infant. The breast first produces colostrum, a yellow, watery fluid, rich in factors that protect against infectious diseases to which the mother may have been exposed. Feeding every two to three hours stimulates abundant milk production by the third or fourth day. After Caesarean births, this will take a few days longer.
Normally, babies feed fully in 30 minutes and can then go two to four hours between feedings. When breast-feeding, use both breasts each time, alternating which is offered first. A rigid schedule will not be necessary. Your baby will teach you his needs. Babies also like to suck even when not hungry to center and soothe themselves. The best available medical evidence states that pacifiers have no deleterious effect on breast feeding. Continue your prenatal vitamins during breast-feeding, but consult us before taking any other medicines. Drink plenty of fluids. Do not eat any foods that do not seem to disagree with your baby.
Use only an iron-fortified formula, not a low iron formula! You will then prevent iron-deficiency anemia, a very important goal. The iron-fortified formulas do not cause constipation. Pre-mixed, concentrated, and powdered formulas are all equal in nutritional content.
Bottles prepared with formula mixed with tap water do not need to be sterilized. Well-water is discouraged for use in infant feeding. Most infants consume two to four ounces per pound of body weight per day after the first week. After the first month, most babies take 24 ounces per day.
Before establishing normal weight gain (usually one ounce per day in the first few months), some babies will lose 10% of their birth weight in the first few postnatal days. After 10 to 12 days, however, the birth weight is usually regained.
New York State requires that a blood specimen from your infant be obtained before discharge and sent to special labs for screening to prevent mental retardation from diseases that are treatable. Other diseases, such as Sickle Cell Anemia and HIV, are also included. We receive prompt reports of any abnormality and will notify you immediately of any concerns about your baby.
Some infants will look yellow during the first few days of life. This color change is called "jaundice." We will explain the significance of jaundice for your infant if it occurs. Usually, no disease is involved, and your infant will remain healthy through this period.
The cord remaining after delivery will dry up and fall off in two or three weeks. Purple antiseptic dye used in some nurseries may stain the adjacent abdomen, causing it to look "bruised." It is not. You may cleanse he area around the base with alcohol every day or leave the cord alone to dry out on it’s own. When the cord falls off, you may see a small amount of blood. Do not worry about this if it happens. Your baby will not continue to bleed from this area and the umbilical-cord area will not open up in any way. You may bathe your baby after the cord falls of. If you notice the umbilical cord has a foul odor or is red and tender please call for us to take a look to ensure no infection.
To circumcise or not is primarily a decision shaped by cultural and religious preferences. Opinions change from year to year about the medical indication for circumcision. Obstetricians will perform the circumcision if you ask for and sign permission for the procedure. Keep the circumcised penis clean, applying antibiotic ointment to the site until it is healed, usually within seven days.
Infants may sleep up to 18 hours per day. This is normal. They also normally sneeze, burp, spit up, and startle after sudden movements or loud noises. They also like to cry! You will quickly learn what your baby is trying to tell you. Listen and look. Do not panic when your baby cries. Call us if anything confuses or worries you.
Babies do not need trips to restaurants or nearby malls. They do not owe friends and casual acquaintances kisses or handling. Increased contact with people exposes your infant to disease, especially during respiratory disease reasons.
Fever Under Four Months of Age:
First of all, learn to take your baby's temperature rectally. Digital thermometers are cheap and easy to use. If you think your baby has a fever and his rectal temperature is over 100 degrees, call us immediately! Do not give Tylenol or Advil without our permission. We presume your infant in this age group has a serious infection until we check for the cause of the fever and perform the indicated tests. An infant under four months of age who has a fever is presumed to be seriously ill until we prove he is not!
Other Significant Signs:
For any change in activity from normal: poor feeding, decreased urination - if your intuition tells you things are not right with your infant, call us.
The schedule for immunizations in childhood is formulated to protect your child from diseases when your child is at highest risk, and to enable your child to form antibodies for protection in case of future exposures. Vaccines are improved through research and development, and new ones are added to combat emerging bacteria and viruses. You will be given information about any vaccines to be administered and will be asked to sign for any shots before they are given. We follow the schedule formulated by the American College of Immunization Practices, the American Academy of Pediatrics and the Center for Disease Control. We believe that vaccines are one of the best health care gifts you can give your child and have seen their life saving results. We require all of our patients to be fully vaccinated unless there is a medical or religious reason not to do so. To protect our patients and your own child, we ask that if you desire not to immunize your child you seek pediatric care elsewhere. See the Schedule.
Clothing and Thermostat:
Dress your infant in the same number of layers of clothing as you wear. A hat is an important addition to keep your baby warm and to allow calories fed to be used for growth instead of keeping the baby's temperature in the normal range. Any temperature from 68 to 72 degrees is satisfactory for your home. Using a humidifier in the winter will keep the home more comfortable as well.
Odds and Ends:
Nursing babies get sucking blisters on their lips that peel off and recur. This is normal.
Facial rashes resembling acne come and go and are normal. Greasy, scaling rashes on the scalp, forehead, or behind the ears are also common. Red, pimply diaper-area rashes or white, patchy areas inside the mouth are not normal and can be treated.
Breasts and genitals of newborn infants are commonly swollen from the effects of maternal hormones. This will subside. Both boys and girls can secrete milk from their swollen breasts. This is not a concern. Bloody mucoid vaginal discharge in female infants is also a normal finding.
Spitting up is a common event. Large regurgitated volumes should be reported. If you think your baby is not tolerating the feedings, call us for advice before making any changes.
You may cut your baby's fingernails with a cuticle scissor or file them down if long nails are scratching your baby's face. We have found that using a nail clipper may lead to cut finger tips.
When you go home, call us to schedule your baby's first appointment. We would like to see you within two days following discharge from the nursery.
Remember to enjoy yourself and your baby. These first weeks and months are a special time for your family.
Congratulations on your new arrival! You are about to begin one of life's great adventures, watching your infant grow and develop into a strong and healthy child.
During the next few days, most of your time will be spent resting and regaining your strength. You can put this time to good use by getting to know some of the simple things that will help to make your life with baby easy and fuss-free.
Your child is an individual from the day he or she is born. We will be happy to give you guidance and answer your questions while you are in the hospital and later by phone and during your visits.
Please click through the categories below to read more information.