Congratulations, your beautiful baby has finally arrived.  It’s exciting, wonderful, overwhelming, and exhausting all at the same time.  I recall bringing home my baby from the hospital and thinking, ‘now what’ (and this coming from a pediatrician).  Soon you’ll find your rhythm.  You’ll get to know your baby’s cues for feeding and sleeping, what each different cry means and which sounds are worrisome and which sounds aren’t.  Until then, here are a few pointers.

Safety

  • Car—use an infant seat, in the back seat of the vehicle, rear facing (I like the 5 point harness style that allows you to pull the straps tight against the infant’s chest)
  • Sleep—
    • The crib is the safest place, slats <2 3/8 in. apart
    • On your baby’s back (this is to reduce the risk of SIDS)
    • No extra soft bedding (quilts, comforters), pillows, toys, positioners (these are also suffocation hazards)
  • Water heater <120 degree F (prevent scalding)
  • Keep home and car smoke free

Nutrition

  • In breastfeeding it is hard to tell how much your infant is getting (unless you have a good pump and you pump once before a feed).  Consequently, we indirectly measure input, by measuring output.  Your baby should be having 6-8 wet diapers a day.  Less than that can be a sign of a problem.  Clearly as a pediatrician it is my job to extol the virtues of breastfeeding, but you can see all that on the separate link (and have questions answered and troubleshoot problems).
  • Formula feeding.  If you choose to feed your baby with a formula, you need to use an iron fortified formula.  Nearly all infants (on formula) should use a cows milk based formula.  There are very few medical indications to stray to hydrolyzed formulas.  The latest and greatest in formulas is trying to imitate breast milk and this contains the ingredient DHEA (claiming it is better for your baby’s brain).
  • Supplements:  If breastfeeding (exclusively)—Vit D 200 IU per day for baby (to prevent Ricketts)

 Milestones

  • Will visually fixate
  • Has a startle reflex
  • Moves all extremities
  • Responds to sound by crying or blinking

 Worry Signs

  • Fever >100.4 (measured rectally)
  • Poor feeding
  • Vomiting (not just spiting up)
  • Extreme or unusual irritability (don’t underestimate your parent instinct, if you think something is wrong, there probably is)

 Is this normal?

This last little section I like to call, ‘is this normal,’ comes from years of getting the same questions from parents of this age group as to whether or not these behaviors are normal.  And the overwhelming answer is–YES!!

  • Hiccups
  • Eye rolling (esp. right before falling asleep or during feeding)
  • Frequent startling
  • Whimpering noises
  • Sounding congested
  • Vaginal discharge/spot bleeding
  • Insatiable desire to suck