Age: Newborn

Congratulations, your beautiful baby has finally arrived.  It’s exciting, wonderful, overwhelming, and exhausting all at the same time. 

January 24, 2024

Congratulations, your beautiful baby has finally arrived.  It’s exciting, wonderful, overwhelming, and exhausting all at the same time.  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

  1. 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)

  2. For help securing the seat make an appointment with a Nationally Certified Child Passenger Safety Technician (to find a location nearest you visit https://highwaysafety.utah.gov/seat-belts-and-car-seats/car-seat-safety/)

Sleep:

  • The crib or bassinet is the safest place.

  • 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: Water heater less than 120 degree F (to prevent scalding) and sponge baths only until the cord falls off.

  • Smoke: Keep home and car smoke free.

  • Sun: Limit sun exposure.

Nutrition

  1. Breastfeeding. When breastfeeding it is hard to tell how much your infant is getting (unless you have a good pump and you pump occasionally before feeding).  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. Most babies this age feed about 8-10 times a day (roughly every 2-3 hours) and take 20-45 mins to feed. The feeding pattern has a lot of pauses at this early stage.

  2. 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 cow’s milk-based formula.  There are very few medical indications requiring hydrolysed or hypoallergenic formulas (plus, they are expensive).  If you’re looking for cost savings, generic formula is the cheapest. Make sure you always mix formula according to the can directions.

  3. Supplements: Only needed if breastfeeding, give your baby Vit D 400 IU (international units) per day (to prevent Ricketts or soft bones).

  4. Water: Do NOT give your baby any straight water prior to 6 months.

Sleep

  1. Most newborns sleep a total of 16-17 hours in a 24 hour period.

  2. They often have their days and nights mixed up. To help:

    1. Try to keep room dark at night (use a nightlight if needed).

    2. Keep your baby calm and quiet when changing and feeding at night (limit talking and stimulation).

    3. Make daytime playtime (lights on, talk with your baby).

  3. Note: most newborns sleep best when swaddled (imitating the womb environment).

Milestones

  1. Will visually fixate.

  2. Has a startle reflex.

  3. Moves all extremities.

  4. Responds to sound by crying or blinking.

ILLNESSES AND WORRY SIGNS

Limit exposure to public/sicknesses. The first 2 months of life are the most critical in terms of staying well. If your baby gets a fever, there is good chance he/she will be admitted to the hospital. So, better to keep your infant at home, away from potentially sick people. Make sure everyone who comes to visit is healthy and washes hands before touching your baby. Bring your baby to our office (if during the day) or to the Emergency room (if at night) if your infant has any of the following in the next 2 months:

  1. Fever >100.4 (measured rectally).

  2. Poor feeding.

  3. Vomiting (not just spit up).

  4. Extreme or unusual irritability (don’t underestimate your parent instinct, if you think something is wrong, there probably is).

IS THIS NORMAL?

All of the following behaviors are normal in infants this age, so don’t worry.

  1. Hiccups.

  2. Eye rolling (esp. right before falling asleep or during feeding).

  3. Frequent startling.

  4. Whimpering noises.

  5. Sounding congested (small noses make for tight nasal passages) .

  6. Vaginal discharge/spot bleeding (this is a hormonal response post pregnancy).

  7. Breast buds (this is also due to a hormonal response post pregnancy).

  8. Insatiable desire to suck.

HOME ACTIVITIES

Between now and the next visit these are things you can work on with your infant to help your infant’s development.

  1. Tummy time (while awake, a few minutes each day, arms in front of the chest, work on upper body and neck strength).

  2. Provide pictures, toys, and mobiles for your infant to look at.

  3. Talk to your infant.

  4. Play soft music.

  5. Hold/cuddle your infant (you cannot “spoil” your infant by holding him too much).

  6. Respond to your infant’s cries immediately; it develops trust and is his way of telling you something is wrong.

YOUR NEXT VISIT

Your baby’s next well child check is at 2 months of age. The vaccines at that visit are: DtaP (diphtheria, tetanus, pertussis), IPV (inactivated polio), Hib (Haemophilus influenza type b), Hepatitis B, PCV-13 (covers 13 types pneumococcal disease), and Rotavirus (oral vaccine for viral diarrhea). Note: There are combination vaccines available to reduce the number in injections.

VACCINES FOR PARENTS/CAREGIVERS

If you (or immediate caregivers and/or siblings) haven’t had the TdaP (Tetanus, diphtheria, and acellular Pertussis) shot, get it now to protect your infant. Also get a flu shot if seasonally appropriate.

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