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Newborn Care

Feeding

Breastfeeding

The benefits of breastfeeding are well known. Human milk is designed especially for human babies, is easy to digest and is chock-full of infection-fighting antibodies. Each time your baby breastfeeds, you are providing your baby with a natural immunity to combat viruses and bacteria that are in the immediate environment. As a result, breastfed babies develop fewer ear, stomach and respiratory infections.

Because breast milk is easy for your baby to digest, your breastfed baby may want to eat every 1-1/2 to 2-1/2 hours. During a growth spurt, your breastfed baby may resemble "a very hungry caterpillar" and want to feed all day with no apparent schedule.

Most babies will offer cues when they are hungry. Crying, sucking or rooting may all be signs that your baby would like to nurse. To enhance your milk supply and satisfy your baby's hunger, we recommend that you watch your baby and feed on cue, rather than watch the clock.

Some moms will not produce milk right away, especially after having a Cesarean section. The more often a baby nurses or milk is expressed from the breast, the sooner the milk will come. Instead of supplementing with formula and waiting for the milk to "come in," a new mother can help to increase her milk supply by having her baby latch on every 2 to 3 hours. Using a breast pump, after or in-between feeds, can also help speed-up milk production.

Some babies will lose up to 10% of their birth weight before reaching their birth weight again at 2 weeks of life. Signs that your baby is getting enough to eat include having at least 4-6 wet diapers and 2-3 bowel movements in a 24-hour period. Your pediatrician will be looking for a weight gain of 1/2 to 1 ounce per day.

While breastfeeding is the most natural way to feed your baby, it does not always come so naturally for each mom and baby. It may take several weeks to perfect your baby's latch, improve positioning and enhance your milk supply. With the right support from family, pediatrician and lactation expert, breastfeeding can be a rewarding way to nourish and bond with your baby.

Supplementary Bottle

Once breastfeeding is well established, usually around 3 to 6 weeks of age, you can offer your baby a bottle of pumped breast milk once daily so that he/she will accept bottle feedings easily. This will not disturb your breastfeeding relationship with your baby.

Mother's Comfort
If you experience discomfort from engorgement, you can try expressing milk, manually or by pump, or applying a moist warm compress for 10 to 15 minutes. Frequent feedings, changing feeding positions and applying cool compresses after a feeding may help to reduce discomfort. Other causes of breast discomfort are dry, cracked or bruised nipples. Leave your nipples open to the air when possible. Gently wipe them dry after each feeding or coat with a thin layer of your own breast milk. Application of 100% lanolin ointment may ease some of the discomfort.

Mother's Diet
Most mothers are able to eat all types of foods while nursing. Drinking plenty of fluids and eating a healthy diet will benefit you and your baby. If you must start any medication, please let your pediatrician know as soon as possible.

Bottle-Feeding
Formula-fed babies usually need to be fed every 3 to 4 hours. The amount of formula may vary. Sometimes your baby will take 4 ounces, and sometimes only 1 ounce - this is normal. As your baby grows, he/she will require more formula.

If you warm the formula, put the bottle in a pan of hot, but not boiling, water for a few minutes or use a bottle warmer. Test the temperature of the formula by shaking a few drops onto the inside of your wrist. It should feel warm but not hot. Most babies do well with cold formula. Do not use a microwave to warm milk, as it can cause severe mouth and lip burns.

Positioning
Feeding is one of your baby's first pleasant experiences. Both of you should be as comfortable as possible and we recommend that you hold your baby for all feedings. Cuddle your baby in a semi-upright position. Often a pillow on your lap is helpful. It is a time for you and your infant to relax and enjoy each other.

Burping
Burp your baby frequently during feedings and again after a feeding is finished. Even if your baby is fed properly, air may be swallowed. Air can be expelled by holding your baby upright over your shoulder, or by sitting him/her on your lap and gently patting or rubbing his/her back. It is normal for your baby to "spit up" small amounts of curdled milk with burps.

Sanitation
Bottles and nipples should be washed with hot soapy water and thoroughly rinsed. Boil new nipples and bottles before their first use.

Other Foods
Breast milk or formula is the primary food source for your baby during the first 12 months. Iron fortified cereal should be introduced at 6 months of age. Solid foods or juices are not recommended before 6 months. Breast milk or formula will contain all of the water that your baby needs, except during unusually hot weather. Water may be used directly from the tap and does not need sterilization.

Stools
Within the first day of life your baby will have a first bowel movement, known as "passing meconium." Your baby's stools will transition from thick, dark green to a lighter yellow-green color. If your baby is breastfed, the stools should eventually resemble light mustard with seed like particles (soft and even slightly runny). If your baby is formula-fed, the stools will be tan or yellow in color, and will be firmer than that of a breast-fed baby, but no firmer than the consistency of peanut butter. Keep in mind that occasional variations in color and consistency of the stools is normal.

Jaundice
Your newborn's skin may appear yellow. Jaundice usually peaks during the first 3 to 5 days in healthy newborns. Frequent feedings and exposure to indirect sunlight for 15 minutes, 4 times a day can help to reduce jaundice. Be sure to call your pediatrician promptly if your child becomes very yellow, listless, stops wetting diapers or stops wanting to eat.

Signs of Illness
Please call your baby's pediatrician if your baby:

  • has a temperature of 100.4ºF or above (ear, rectal or armpit)
  • experiences difficulty breathing
  • experiences repeated vomiting
  • is listless or inconsolable
  • is refusing to eat
  • has less than 4 wet diapers in 24 hour
  • is becoming more jaundiced (yellow)
  • has any signs that concern you

If your new baby has any of these problems, a Sansum Clinic pediatrician is always available. For emergencies, call 911.

Office Visits
Your baby's first office visit should be scheduled within the first 2 to 4 days after leaving the hospital to check for jaundice, discuss feedings and to help answer your questions. Your pediatrician will schedule subsequent check-ups.

Car Seats
Make your baby's first ride home a safe one. You should have a federally approved car seat to take your baby home from the hospital. No matter how short the drive, please use the car seat on every automobile ride. Remember that babies should be rear-facing until they are 20 pounds and 1 year of age. Loving arms alone are never safe, even during minor accidents.

Immunizations
Immunizations are important and should be started when your baby is 6 to 8 weeks old. Your baby will receive protection against diphtheria, tetanus, pertussis (whooping cough), polio, Hemophilus Influenza type B, strep pneumococcus, Hepatitis A & B, measles, mumps, rubella and varicella (chicken pox).

Watch Dr. Saida Hamdani discuss infant immunizations:

Friends & Relatives
New babies are susceptible to colds and illness. It is important to allow only people without colds or other infectious diseases to hold your baby. If a family member has a minor illness, he/she is likely to give it to your baby. Good hand washing is the best way to prevent the spread of illness.

Babies Are Babies
All babies sneeze, yawn, burp, hiccup, pass gas, cough and cry. Sneezing is the only way a baby can clear his/her nose of mucus, lint, or occasional milk curds. Hiccups are harmless spasms of the diaphragm muscle and may be stopped with a few swallows of warm milk or breastfeeding. Coughing is the baby's way of clearing his/her throat.

Crying is your baby's way of telling you that he/she is hungry, too cold or too hot, wants to be held or needs a diaper change. You will gradually learn to recognize your baby's needs. Even a healthy baby will cry for an hour or so without doing any harm. Most babies will cry, grunt, strain, and turn red during a bowel movement.

Infant Stimulation
An infant loves the touch, voice and stimulation of his parents and caregivers. Time spent talking, singing and reading to your infant is the best way to promote development and socialization skills. Babies like to focus on their parent's faces and objects with great contrasts of colors. Despite clever marketing, propping your infant in front of the television screen for hours will probably not produce a baby genius.

Daily Care
Navel

Usually your baby's umbilical cord will fall off in the first 1 to 4 weeks. Please keep it clean and dry. Application of rubbing alcohol once daily can help prevent odor and infection. Call your pediatrician right away if you see redness or pus coming from the belly button.

Circumcision
The area where skin was removed may look raw and swollen during the first week. Apply petroleum jelly to the raw area with each diaper change to prevent sticking until the skin has completely healed.

Bathing
You may sponge-bathe your baby until the umbilical cord falls off and the circumcision heals. Use any mild soap. Bathing two to three times per week is quite adequate, but you may do it as often as you wish.

Eyes
To clean eyes, use cotton dipped in cool water.

Nose and Ears
Cleanse outer areas with only a moist cloth or tissue. Put nothing smaller than your elbow in your baby's ears.

Head
Lather your baby's head gently to clean hair and remove dry, peeling skin. Work from front to back to keep soap out of his/her eyes. Do not be afraid of your baby's soft spot. You may use a mild soap or baby shampoo.

Body
Use any mild soap. Wash in the creases, rinse the skin and dry well.

Skin
During the first few weeks, your baby's skin will dry and peel, especially on the hands and feet. Ask your doctor about any rash. Many babies get pimples on their face, scalp, and chest at 2 to 6 weeks of age. This condition does not require treatment and does not predict your child's teenage complexion. It will resolve in 1 to 2 months.

Some babies have sensitive skin. Hypoallergenic and fragrance-free products tend to be the most gentle on your baby's skin. Just because it is "natural" or "made for babies" doesn't mean that it can't irritate.

Diaper Area
Change your baby's diaper every 2 to 4 hours when he/she is awake, or as soon as possible after each bowel movement. Wash the diaper area with a soft cloth and mild soap and water. Pat dry thoroughly. You may apply zinc oxide cream to help prevent and treat mild diaper rash. A small amount of bloody discharge from a newborn girl's vagina is normal in the first 2 weeks.

Room Temperatures
Attempt to keep an even, comfortable temperature in your baby's room (68° -73° F).

Sleeping
Your new baby may do a lot of sleeping. However, some babies require relatively little sleep - as little as 14 hours a day. Infants should always sleep on their backs to prevent SIDS (Sudden Infant Death Syndrome).

Clothing
Dress your baby as you would dress, with the exception of one extra layer when sleeping. Some babies are sensitive to certain materials, so watch for rashes in clothing contact areas. You should wash new clothing before dressing your baby. You may wish to wash the baby's clothing separately from the rest of the family's for the first month.

Outdoors
You may take your baby out for walks as much as you like, but avoid crowded places. Your baby's eyes may be sensitive to sunlight. Also, your baby's skin should be protected from sunburn by avoiding direct sun exposure, wearing lightweight long pants and sleeves, a brimmed hat and applying a minimal amount of sunscreen if necessary.

Congratulations, again, on the birth of your new baby! It is a privilege for us to care for your newborn. Your questions are always welcomed. We look forward to watching your baby grow with you!

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