The Newborn Visit
Nutrition:
- Breastfeeding- offer breast on demand every 1.5 to 3 hours, 8-12 x/24 hours
- Formula- offer 2-4 oz every 3-4 hours, 7-8x/24 hours
- No need to wake at night once baby has returned to their birth weight
- No need to sterilize bottles
- Vitamin D for breastfed infants (400 IU/day)- this may begin at one month of age
Safety:
- Do not leave infant alone on elevated surface even "for a second"
- Always strap baby into car seat and fasten any necessary attachments to stroller
Common Concerns:
- Stools: Tarry stools (meconium) transitions to brown mucousy stool and then to yellow, seedy watery stool in the first week
- After that stools can be green, yellow, orange or brown and liquidy
- Babies grunt and appear to strain with stooling; if stool is soft, babies are NOT constipated
- Initially babies stool with each feeding (gastro-colic reflex), this stool pattern eventually slows down. Breast fed babies can go ONE WEEK without having a bowel movement, as long as it is soft when they go, they are passing gas, and voiding regularly.
- In the first week of life, urine diapers should correlate with the number of days they are alive. After 1 week, babies should void at least 6x/24 hours.
- Congestion is normal. Sneezing is a way to clear out nasal passages and is also normal. Baby saline spray can help clear nasal passages.
- Hiccups are normal and do NOT bother babies. You can feed through hiccups.
- Sleep-always put babies to sleep on their backs in a separate bassinet (not in parents bed) and start ‘tummy time’ on a blanket/mat on the floor once the belly button falls off.
- Dry skin/peeling skin is normal. Baby lotions are fine but not necessary. Gently rubbing baby oil on dry areas of the scalp is fine. Avoid use of baby oil on the body.
- Various rashes are normal at this time
- Sponge bathe until cord falls off and is dry
- No stuffed toys, pillows, plush bumpers or blankets in the crib. It is ok to take walks outside
- The cord can be left alone or cleaned with alcohol and a cotton swab several times daily
- Pacifiers are ok to use-baby's suck for comfort as well as nutrition
When to call us:
- Rectal Temperature >100.4 F (38 C)
- Crying excessively or inconsolable
- Difficulty breathing (rapid/shallow breathing, sucking in chest muscles,not just nasal congestion)
- Unusually sleepy or poor feeding
- Vomiting forcefully or frequently
- If baby appears more jaundiced (yellow)
- Limited urine output (less than 3-4 wet diapers/day)
- OR if you have any questions or concerns