Expecting Parents

Before your infant goes home from the hospital, you will need a car seat, formula bottles (if you are not breastfeeding), rectal thermometer, nasal aspirator/bulb suction, and diapers.

Some things which may not constitute an emergency in an older child are a cause for concern in a baby under 3 months of age. Please call us immediately if you feel there is any problem with your baby or if your baby has any of the following:

A rectal temperature of 100 degrees Fahrenheit or more or 98 degrees and below

A sudden decline in feeding pattern lasting over two consecutive feedings (6-8 hours)

Persistent crying lasting over one hour without interruption

Significant vomiting (not just spitting up) or spitting up green material

Diarrhea/frequent loose, watery stool

Jaundice/yellow color of the skin, eyes

Difficulty breathing

Unusual rash

Listlessness

Color changes

Fever or low temperature in newborns is a sign of illness and requires immediate evaluation. For this reason, getting an accurate temperature is very important. The temperature does not need to be taken routinely, but should be taken anytime you have concerns about the baby. If your baby feels warm, is fussy, is not feeding well or you see any signs that cause you concern, you should measure the temperature. A rectal temperature is best for newborns.

Clean the end of the thermometer (do not rinse with hot water)

Put a small amount of lubricant (petroleum jelly) on the end

Turn on the thermometer and insert the tip .5 to1 inches into the anal opening

Hold in place for 1 minute, until you hear a beep

Remove the thermometer and check the digital reading

Every baby is different and feeding efficiently takes practice for a new baby. Additionally, nursing mothers will not know exactly how much the baby is getting. Most full term, bottle-fed newborns are taking 2-3 oz per feeding by the end of the first week of life. The best gauge of adequate feeding is a satisfied baby along with frequent stooling and urination.

Sleep requirements vary greatly, but most newborns will sleep an average of 17-18 hours per day in the first week. As the baby becomes more alert, the amount of sleep will decrease to around 15-16 hours/day in the first month. Don’t expect this sleep to be continuous, as most newborns will only sleep for short intervals at a time, in between feedings.

Parents will always enjoy better sleep when the baby starts to sleep for longer intervals. Most babies start to sleep better by the end of the first month and about half are sleeping continuously through the night (7-9 hours) by 2-3 months. If things are not getting better by that time, then you should talk to your physician about some ways to improve the baby’s sleep pattern.

Different hospitals give different recommendations with regard to cord care.  Some may have you do nothing while others recommend cleansing with an alcohol swab. The goal is the same: to keep the cord clean and dry so that it falls off by itself over 1-4 weeks. You may notice a clear to slightly blood-tinged discharge oozing from the navel for a few days after the cord falls off. You should call your physician if there is drainage that lasts longer than 2-3 days, has a foul odor, or if there is redness in the skin surrounding the cord.

This varies depending on the urination and stooling pattern of the baby. Change the diaper whenever the baby is soiled or wet. Initially this will probably be every feeding but usually gets less frequent when the baby gets older.

You will be cleaning the diaper area frequently, so bathing often isn’t necessary. Bathing every few days is fine. Giving a bath can be enjoyable and soothing, however, so giving one each day as part of the baby’s routine is also okay.

This is a cultural decision. Medical benefits including a decreased risk of urinary tract infections and penile cancer are negligible as these disorders are so rare to begin with. It is, however, a decision that should be discussed prior to delivery of the baby. That way you are not put on the spot to make this decision immediately after the baby is born.

Clean the circumcision site gently with plain water, and then apply a small amount of antibiotic ointment (usually supplied by the hospital) or petroleum jelly with each diaper change. Continue this for 2 to 3 days after the procedure and keep the diaper loose until the area is healed. It is normal for the circumcised area to have a slight amount of bleeding for several hours after the circumcision. If the bleeding continues after you get home, you should call your physician. Some yellow scabs may form around the penis, stay for about one week and should not be removed. This is a normal part of the healing process.

Breast feeding is always the healthiest choice for both mother and child. We have a lactation consultant on staff that all breastfeeding mothers see to help with any problems they might encounter.

Breastfeeding is a natural process, so if things feel right and your baby seems satisfied, is urinating, stooling, and gaining weight, then those are all good signs that you are doing well. Involving a lactation consultant in the initial weeks of breastfeeding is recommended can be very helpful, even if there are no concerns about the feeding.

Crying is a baby’s way of communicating and could mean any number of things from hunger to discomfort. Over time, as you become in tune to your baby’s temperament, you will get a better idea of what the crying means. If it is prolonged however, and the baby cannot be consoled, you should seek the advice of your physician.

Rocking, swinging, playing music or any number of things may be helpful in soothing your baby. Sometimes a baby just wants to be picked up or carried. In the first few months of life, you cannot “spoil” your newborn, so you must attempt to console in whatever way works. A great book or video called “The Happiest Baby on the Block,” by Dr. Harvey Karp gives great recommendations on ways to soothe crying babies and get them to sleep for longer intervals.