Baby Babble

FEEDING YOUR BABY

According to the American Academy of Pediatrics, breast milk is the best food for babies during the first year. We strongly support breast-feeding because breast milk contains the proper nutrients for optimal growth. There is some evidence to suggest that it may protect a child against certain illnesses and allergies. Breast milk has such a high degree of digestibility that breast-fed babies tend to be less gassy, less constipated and less “colicky.” Mothers taking medication should check with the prescribing doctor prior to breast-feeding since all medications have the potential of passing into breast milk to some degree. The hospital's lactation consultant can be very helpful in this area. Make sure you eat a balanced diet and take your prenatal vitamins. Nurse your baby for 10 to 15 minutes on each breast. Normally, breast-fed babies are fed every two to three hours, and often this takes place round the clock. If nursing is going well, you can expect the baby to appear satisfied after a feeding. Typically, they fall asleep. Also, expect to change six to as many as twelve wet diapers daily. Lastly, expect several "poopy diapers" daily. If you are unable or opt not to breast-feed, don't despair! Being a good mom involves more than simply breast-feeding your child. Today's formulas are excellent; your baby will do fine! Generally, a milk-based formula such as Enfamil, Similac, or Good Start is used, unless the baby demonstrates intolerance to such a formula usually by exaggerated vomiting. Often, there exists a strong family history of lactose intolerance. In such cases, a lactose-free formula such as a Lactofree, or perhaps a soy-based formula such as Prosobee or Isomil may be used. Bottle-fed babies are fed every three to four hours. Some babies will take more, some less. A common question is, "how much formula should my baby be taking?" A maximum volume can be hard to predict. Some babies, especially large babies, consume large volumes of formula. Minimum feedings however, can be estimated on the basis of 2 to 3 ounces per pound per day consumption. For both breast and bottle, feed the baby on-demand. No cows milk or baby cereals yet, please. Burp your baby after each breast or after every ounce initially, and for no more than 3-5 minutes; then, feed some more. Spitting up with burping is normal and happens to all babies.

 

NEWBORN SCREENINGS:

The state of New Jersey's Department of Health requires that all newborns undergo a blood test which screens for certain metabolic disorders, thyroid gland disorders, as well as certain abnormalities related to red blood cell function. In the case of inherited metabolic diseases, specific enzymes which aid in the processing of nutrients, are not present or do not function properly. As a result, a baby’s physical and or mental development can be severely altered. The screening test for these conditions is state mandated and performed while your baby is still in the hospital, thereby allowing for very early treatment when needed. Finally, a hearing screening test will also be performed on your baby prior to discharge. This test is also mandated by the State of New Jersey, and its purpose is to help identify those newborns that COULD HAVE hearing inadequacies. It is important to understand that this test is designed to be a screening tool only.

SOLID FOODS:

Introducing solid foods too early is not good for your baby; their digestive systems are not ready. Be aware that formula or breast milk plus cereal have never been proven to improve an infant's sleeping pattern.

VITAMINS:

Vitamins guarantee that your child receives all the essential nutrients needed for proper growth. You will be given instructions for the administration of vitamins in the office. BATHS: Avoid placing the baby in a bath until the umbilical cord has dried out and fallen off. After that, one bath per day is more than enough. Use only warm/lukewarm water and a small amount of mild soap. Avoid the eyes, and do not attempt to clean inside the baby's ear canals with Q-tips. A newborn baby’s ear canal is very small and the Q-tips are relatively large. They will tightly pack-in the earwax, obstructing the vision of the examiner and ultimately make it more difficult for the wax to be removed.

 

SLEEPING:

Frequent nighttime feedings and an irregular sleeping pattern are two of the most difficult things which new parents have to deal with. Newborns have no sense of night or day. Normal newborns sleep between 11 and 23 hours and the average sleeping time is about 16 ½ hours out of the 24-hour period. Remember also, that this sleeping time includes naps during the day. In addition, the definition of sleeping through the night is "sleeping for five hours" from midnight to 5 a.m. for four weeks. This is probably not what most parents would consider "sleeping through the night." Generally, by 3-4 months of age and sometimes sooner, babies will start to sleep through the night.

 

BOWEL MOVEMENTS:

Newborns "poop" several times a day or once every several days. The blackish, tarry looking stool called meconium is usually gone by the time the baby leaves the hospital. Generally, babies stool very frequently in the first week of life. Their overactive gastro-colic reflex usually produces a stool after every feeding. Their stooling pattern usually slows down after the first 1-2 weeks. It is not unusual for a 1-2 month old baby to poop only once every 2-3 days. Stools are generally very loose or pasty and may vary from day to day. The color will vary as a function of the type of milk used. Breast-fed babies produce a watered down, yellow, mustard-colored stool. Formula fed babies produce a yellow, brownish or greenish, loose, seedy mush. A consistently formed stool can be a sign of constipation.

 

CRYING:

Crying is a form of communication, and babies have different cries. Generally, they cry when they want to be fed. Sometimes, they want to be changed, or they want to be held. Sometimes, babies simply want to cry and "let off steam." If you've checked the infant and can identify no source of possible irritation, let the child cry for 20 minutes. Most of the time they will fall asleep long before then. If not, you may want to discuss the crying with one of our office staff members. "Colic" is a prolonged period of inconsolable crying unassociated with other findings. It generally occurs about the same time each day, beginning around two to four weeks of life. It may last two to four months, and unfortunately, sometimes longer. Its cause is unknown, but the good news is, it always goes away! Strategies to alleviate "colic" include: a warm bath, "white noise" such as a vacuum cleaner or music, a crib vibrator, a snug swaddle, pacifier, or even a ride in the car. These distractions will often "reset" the baby's mood.

 

TEETHING:

Many babies start to teethe at approximately 4 to 6 months. Most babies aren't particularly bothered by it. However, some babies can become very irritable and display difficulty eating and sleeping. Steps that you can take to ease the irritation will be discussed in the office during routine checkups.

 

DIAPER RASHES:

Some babies get diaper rashes more often than others, depending on their skin sensitivity. In general, disposable diapers are more apt to cause rashes, often induced by the absorbent chemicals that they contain. Cloth diapers tend to cause rashes provoked by the excessive "wetness" in continuous contact with the baby's skin. Expect to change approximately 8 to 12 diapers a day initially. Check with the office before using any diaper ointments. The so-called "baby wipes" can often create a rash problem as well.

 

FEVER:

Babies normally run higher temperatures than older children or adults. The safest way to check a temperature in a newborn is under the arm (axillary temperature). Ear thermometers (tympanic thermometers) are quick, and have improved dramatically over the last several years. They tend to read higher from the ear that the child is lying on. For this reason, their accuracy tends to decrease as the age of the child decreases. Rectal thermometers are very accurate and the rectal digital thermometer is very quick to measure temperature. Rectal thermometers however, must be used very carefully. The caregiver needs to be very careful to avoid inserting the tip of the thermometer too far into the rectum, and also needs to take precautions to avoid the infant “kicking” the thermometer, and in so doing, possibly perforating the bowel. Typically, an axillary “reading” tends to be ½ to ¾ of a degree LESS THAN a rectal measurement. However, in most cases, the specific temperature measured is not the most important consideration. Thermometers that are placed on the forehead and those thermometers that are incorporated within the nipple of a pacifier are probably best avoided. In the infant period, temperature greater than 100.4° F is considered a fever and is a sign of illness. Please notify our office as soon as possible if your child is less than two months of age and has a temperature of 100.4°F or higher.

 

VOMITING:

Frequent spitting up can be normal. Occasional vomiting is normal as well. Frequent, forceful vomiting or vomiting that produces bloody or greenish-yellowish material is not normal, and should be reported to the office. COLDS: Babies are obligate nose breathers. Therefore, any condition, which affects the baby's ability to breathe through its nose, will affect the way in which the child sleeps and feeds. An occasional cough is normal. Sneezing is how a newborn clears his or her nose. During the first two to three months of life, a newborn’s breathing can be very "snorty." This results from secretions pooled in the back of the throat, which are coughed or sneezed into the nasal passages. A bulb syringe, used with saline drops may often be helpful in removing excess mucus in some cases. However, overuse of the bulb syringe will cause nasal irritation, which may actually result in increased mucus production.

 

CIRCUMCISIONS:

Circumcisions are one of the oldest operations known to man. Normally, a gauze pad upon which a lubricant such as K-Y Jelly or Vaseline Petroleum Jelly has been applied, is draped over the penis for three to five days to help shield it from the sticky infant stool and to prevent the tip of the penis from sticking to the diaper during this healing phase. Infected circumcisions are very uncommon. The foreskin in an uncircumcised newborn should never be pulled back.

 

BABY GIRLS:

Newborn girls may have a whitish discharge that is normal. In some cases, if the baby girl has been exposed to enough maternal hormone prior to delivery, a "menstrual period" may ensue, resulting in a pink or mildly bloody "mini-period." This may last for two to four days and is perfectly normal.

 

EYES:

Some babies may appear to be intermittently cross eyed at birth. This should resolve by two to three months of age. Following delivery, an erythromycin ointment is applied to both eyes. The puffy eyelids noted soon after birth is often the result of the local irritation from this medication placed in the baby's eyes at birth to prevent infection. Also, babies tend to develop obstructed tear ducts, which generally occur in one eye more than the other but may occur in both eyes. This tends to produce excessive tearing often accompanied by a yellowish- greenish discharge. Warm water soaks with tear duct massage generally resolves the issue. Otherwise, special eye drops may be required, if the discharge persists.