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Tag: baby

Age: Newborn

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Posted by Dr. Monica Wonnacott | August 15, 2020

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. Breast feeding. 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 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.

Age: 9 Months

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Posted by Dr. Monica Wonnacott | July 7, 2020

Nine months is the age of exploration. Your infant is, for good or bad, mobile. Your baby is discovering that he or she can finally get to things of interest and is trying to reach everything. Your baby is learning to communicate and interact with the environment.

Safety

  1. Car: The car seat should be in the back of the vehicle and rear-facing (I like the five-point harness style that allows you to pull the straps tight against the baby’s chest). Most babies transition out of the infant to the bigger convertible car seat at this age. The convertible car seat stays in the car (you don’t lift it out like an infant seat) and can convert to forward facing when your child is old enough/big enough (2+ years old). You will know your child is too big for the infant seat if his or her head comes within an inch or two of the top of the car seat (or surpasses the weight recommendation of the seat).
    1. 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/)
  2. Sleep:
    1. The crib is the safest place; slats less than 2 3/8 inches apart; place the mattress at the lowest setting of the crib.
    2. Your baby can sleep in whatever position he or she finds most comfortable (the risk of SIDS has dropped significantly).
    3. You may put mesh/breathable bumpers back into the crib if your baby is a wild sleeper and arms and legs are getting stuck outside of the slats.
  3. Childproofing: Get down on floor level and look for hazards.
    1. Outlet covers
    2. Safety gates in front of stairs (starting to crawl up the stairs but are high risk for falling down).
    3. Consider what a mobile child can pull down on him/herself (anything with a dangling cord).
    4. Chemicals/medications/cleaners out of reach or locked.
    5. Toys with small parts and sharp objects out of reach (high choking risk at this age).
    6. Keep guns with ammunition separate and in a gun safe.
    7. Do NOT use walkers (they delay walking skills and are high risk for falling down the stairs).
  4. Water: Don’t leave unattended in bathtub and keep water heater less than 120 degree F (to prevent scalding).
  5. Smoking: Do not smoke in the home or in your car.
  6. Sun: Limit sun exposure, use sunscreen when outside.
  7. Choking: Risk of choking is highest at this age (foods, toys, essentially anything that goes in that mouth). Make sure you know how to do “back blows” should that happen.

Nutrition

  1. Continue to breastfeed or use formula. You will not transition to whole milk until 12 months. (total volume is 24-36 oz/day).
  2. Continue offering solid foods. Your infant should be eating 3 “meals” (sitting in the high chair) and 3 snacks a day. Most of the foods will be table style (bites of whatever you are eating), but may also include stage 2 and stage 3 baby foods, depending on your preference.
  3. Offer a cup (typically a sippy style) with eat meal.
  4. Give water throughout the day.
  5. Do not give your child honey (because of botulism risks), there are no other food limitations. You can do milk products (like yogurt or cheese), but not straight milk as your infant needs the extra nutrients found in breast milk or formula.
  6. Nuts. The newest recommendations (as of 3/2019) say you can also introduce nuts/nut products (like peanut butter). You only need to be cautious if there is an immediate family member with a nut allergy (in that case, let me know due to the increased risk of allergies). If giving peanut butter makes you nervous, consider giving it for the first time in the waiting room of your child’s next well visit (that way you are already at the doctor if there is a problem).

Sleep

  1. Should be sleeping through the night and in a crib still.
  2. Typically taking 2 naps a day (a shorter morning and a longer afternoon nap).
  3. Total sleep should be 12-16 hours per 24 hours (including naps).

Milestones

  1. Crawling
  2. Has a pincer grasp
  3. Making consonant sounds (lots of babbling)
  4. Steady sitting and maneuvering without falling over
  5. Waving
  6. Stranger danger is common at this age
  7. Pulling to a standing position

ORAL HEALTH

  1. Do not put your baby to bed with a bottle. It establishes bad habits, causes bottle rot (have you seen the children with rotten teeth or capped teeth?), and is a choking hazard.
  2. Discuss with your pediatrician whether your infant needs supplemental fluoride (this depends on your city’s water supply).
  3. Teething typically happens between 6-9 months. Start brushing teeth (with a non-fluoridated toothpaste) when teeth erupt.

Illness

At this age you may treat fever and minor illnesses at home as long as your baby looks and acts ok swiss replica rolex watches. Bring your baby to the doctor if: symptoms are severe or prolonged (e.g., fever beyond 5 days, bad cough, etc.), your infant isn’t eating well, your infant is particularly fussy, or you are concerned.

YOUR NEXT VISIT

Your baby’s next well child check is at 12 months of age. Vaccines at that visit can be split and given half at 12 months, half at 15 months, or given all at once. They include: DtaP (diphtheria, tetanus, pertussis), Hib (Haemophilus influenza type b), PCV-13 (pneumococcal disease), MMR (measles, mumps, and rubella), Varicella (chickenpox), and Hepatitis A. Depending on the time of year, your infant may qualify for a flu shot (remember, the first time your infant gets a flu shot, he or she will need a booster/2nd dose in 30+ days). Your baby will also get his/her hemoglobin checked at 12 months (typically done with a finger poke) to ensure he or she is not anemic.

Get Ready, Set, Baby Time!

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Posted by Dr. Monica Wonnacott | November 29, 2017

I haven’t posted in a while because I’m in full baby prep mode. We’re on the count down at our house, 2.5 weeks (at the most) before baby #4 arrives. As I have been trying to fit patients in at work before maternity leave, prep for Christmas, and get everything together for a new baby, I realized that having done this before (and at this crazy time of year) really helps. If it’s your first time (or it’s been a while), here are a few tips:

What to buy?

FOR MOM

After you deliver, you may want to have these products at home to help in healing during the recovery process.

  1. Maxi pads (not tampons). There is a lot more bleeding post baby than many woman realize.
  2. Hemorrhoid pads or cream. Even if you don’t have hemorrhoids, the cream can help with all the swelling and vascular congestion that surrounds the vulva.
  3. Comfortable/stretchy underwear. Think grandma briefs (much more comfortable during the initial healing stages) than your cute thongs.
  4. Stool softeners or laxatives. All the pain meds will make stooling difficult (and no one wants to push against tender, torn, or stitched tissue).

 IF BREASTFEEDING

  1. Nursing pads
  2. Nursing bra
  3. Lanolin cream. Your nipples will likely get sore and it doesn’t have to be removed to feed the baby.
  4. Breast pump (strongly consider). A good double electric pump can be a lactating woman’s best friend.

 IF NOT BREASTFEEDING

  1. Ace bandage or tight sports style bra. This will help bind your breasts when/if milk starts to come in.
  2. Medication, like Pseudoephedrine (strongly consider). Medications like pseudoephedrine (a.k.a., Sudafed) can help dry up milk.

FOR BABY

These are the items you are going to need to take care of your baby.

NECESSITIES

  1. Diapers. You’ll get a few from the hospital, but not enough to last. Just so you have an idea, the average infant goes through 8-12 diapers a day. Be cautious about buying too many of the tiny sizes (like “newborns”). If your baby is big, you may end up straight at a size 1.
  2. I like sensitive or hypoallergenic wipes (like Water Wipes). Babies stool a ton in the beginning and their butts are very prone to diaper rashes.
  3. Crib (possibly a bassinet). You will need somewhere for your baby to sleep (and in your bed is not a good option).
  4. Car seat (5-point harness, infant style is best). This is required at the hospital to take your infant home.
  5. Clothes (including onesies and comfortable sleepers).
  6. Blankets (and burp cloths). You may want a few lightweight blankets because babies often spit up and soil blankets. You’ll need a few back up blankets if you don’t want to be doing laundry multiple times a day.
  7. Feeding support materials (breast care items or bottles and formula).
  8. Digital thermometer (rectal). If your child has a fever in the first 2 months of life (anything greater than 100.4 F), you need to know as it constitutes an “emergency.”
  9. Skin care products (diaper cream and hypoallergenic soaps and lotions).
  10. Nail file. You’ll be surprised at how long a baby’s nails can be and how much scratching he/she can do to his/her beautiful face. Typically, filing in the first couple of months is safer than clipping.
  11. Infant vitamin D drops (if breastfeeding).
  12. Petroleum jelly (if planning circumcision).

 NICETIES

  1. Pacifiers. Most hospitals use a “soothie” style brand (these are the blue/green ones that you can stick your finger into to aid in the infant sucking). Long term, these aren’t great binkies because they don’t come in different sizes and can’t grow with your infant, which can create dental problems as the child’s teeth come in.
  2. Monitor. While a video monitor is much more expensive than a simple audio one, they are really nice to have. A video monitor wasn’t economically feasible for our first couple of kids, but having one for subsequent children has been nice (especially for things like watching the child when they are older and you’re sleeping training/crying it out).
  3. Diaper bag. There are really fancy, beautiful bags out there with all the bells and whistles (changing pad covers, wipe holders, etc.). However, if your budget is tight, any old bag can hold some diapers, wipes, and a change of clothes.
  4. Stroller. When we lived in New York City, a stroller would have been classified as a “necessity.” Depending on where and how you live, this purchase can swing hundreds of dollars depending on what you need the stroller to be able to do for you.
  5. Play pen. These are as nice to keep older children out as much as they are to keep baby in. They are nice, but not necessary. They do make for great portable cribs though (especially if you travel or go to grandma’s house).
  6. Bouncer. These come in all sorts of varieties. If you plan on using one with your very young infant (younger than 3 months), make sure that it is pretty reclined (some sit up too much for a young infant to be able to support his/her body).
  7. Swing. Some parents swear by these. I borrowed one for my first kid, hated it and never bothered with subsequent children.
  8. Breast pump (if applicable). 

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Continuing my new baby series today talking about what your baby needs. There are a dozen cool products out there, but what are the basics? ⁠⠀ ⁠⠀ Swipe to watch my must-haves list. Let me know in the comments what you would add, and what cool gadget you can't live without!⁠⠀ ⁠⠀ Tomorrow I'll talk about baby item safety and what you should NOT get. ⁠⠀ ⁠⠀ ⁠⠀ ⁠⠀ ⁠⠀ ⁠⠀ #babyontheway #mothertobe #firstpregnancy #breastfeeding #breastfeedingtips #breastfeedingcare #pregnancydiary #momtobe2020 #smallbabybump #babybump #9monthspregnant #expectingmom #40weekspregnant #36weekspregnant #soontobemom #soontobemommy #bumplife #mummytobe #newbaby #38weekspregnant #30weeks #thirdtrimester ⁠#babymusthaves #babyessentials #babygear #bestbabyitems #bestbabystuff

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What Happens The Day I Deliver?

  • Go to the hospital when your water breaks or contractions are 5 minutes apart, or less.
  • When you arrive, the staff will contact your OB/GYN.
  • If any problems are anticipated with the baby, or if things don’t go well, the NICU or your pediatrician will attend the delivery to assist your baby. Otherwise, your pediatrician will come the following day.
  • Your OB/GYN and pediatrician will see you and your baby each day you are in the hospital.
  • If you have a C-section, plan on needing more help.
  • The average hospital stay (counting the day of delivery) is 3 days for a vaginal delivery and 4 days for a C-section.

Relax, You’re Prepared.

Planning ahead takes the worry out of what can be an otherwise stressful situation. Ask yourself:

  1. Do I have all the products I’ll need for me and my baby?
  2. Have I packed a bag for the hospital (both for mom and baby)?
  3. Do I have the help of family or friends arranged for the first few days home post-delivery?
  4. Have I chosen a pediatrician? If not, start looking. Most pediatrician’s offices will do some version of a complimentary “meet and greet,” which allows you to meet the doc and ask questions before the baby comes. It is a good opportunity to make sure you feel comfortable with the pediatrician because everyone’s style is a little different.

Good luck! Don’t’ worry. At the hospital you’ll be surrounded by experienced people who are ready and waiting to help you.

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First topic in my New Baby series: What to pack in your hospital bag.⁠⠀ ⁠⠀ The good news is the hospital is going to have everything you technically *need* to have your baby and recover. There are a few tips and tricks I have picked up after having my 4 children that I've included in this video.⁠⠀ ⁠⠀ I'd love to hear your favorite things to pack! Leave them in the comments below so our expecting mamas can have a great list to reference. ⁠⠀ ⁠⠀ ⁠⠀ #babyontheway #mothertobe #firstpregnancy #pregnancydiary #momtobe2020 #smallbabybump #babybump #9monthspregnant #expectingmom #40weekspregnant #36weekspregnant #soontobemom #soontobemommy #bumplife #mummytobe #38weekspregnant #30weeks #thirdtrimester

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