Newborn

As new parents watching your baby grow and develop, you will experience many new things, most exciting and rewarding. There will be, however, many problems and questions which will arise. As long as your baby is well-loved, well-fed, warm and comfortable, he/she will do well. Remember, we are available to help with these issues, no matter how trivial they may seem. Loving your child, common sense, and the ability to adapt to particular situations are the keys to successful parenting.

Babies are Babies

All babies sneeze, yawn, burp, have hiccoughs, pass gas, cough, grunt and strain while stooling. They may occasionally look cross-eyed. Sneezing is the only way a baby can clean his/her nose of mucous or milk. Hiccoughs are little spasms of the diaphragm muscle and are harmless. Coughing is the baby's way of clearing the throat. Nasal congestion, causing a "snuffling" sound, is common. This is not usually a cold unless accompanied by nasal discharge. Crying is his/her way of saying "I'm hungry, I'm wet, I'm thirsty, I want to turn over, I'm too hot, I'm too cold, I have a stomach ache," or "I'm bored." You will gradually learn to know what your baby means. The baby just may need to suck, or be cuddled, or may just be expressing him/herself.

Feeding

The choice of whether to breast or bottle feed is up to you. Whichever you choose, we will try to help support you in maintaining the best possible care of your infant.

Vitamin supplements are not needed for formula fed infants. Exclusively breastfed infants may need to take a daily vitamin - your doctor will make the recommendation.

Click here for feeding handout.

Breast Feeding

We strongly encourage breast feeding. Even if the mother is returning to work and can breast feed for only a few weeks, it is still well worthwhile. While adequate milk supply will take a few days to become established, you should start nursing soon after birth to encourage milk production. Find a comfortable place to sit with good back support so you can relax. Nurse the baby on a demand feeding schedule. In general, let your baby nurse until satisfied, starting with approximately 5 minutes on each side and gradually increasing the duration of the feeding to approximately 30 minutes of nursing per feeding. Begin each feeding with the breast used last in the previous feeding. Newborn babies should generally eat every 2-3 hours, to equal 8-12 feedings a day.

Breast Feeding Support

All of our staff have received training on breastfeeding basics and can assist mothers with breastfeeding issues during office hours. We are now pleased to offer the services of a Lactation Consultant to see mother-baby pairs during follow-up visits. During these visits, in addition to weighing the baby to monitor weight gain, a feeding is observed to assess latch and positioning and allow the mother to express concerns or have questions answered.

Joy Nichols has been a registered nurse for over 25 years and worked 14 years in the NICU and Newborn Nursery at Piedmont Hospital. Joy is an IBCLC (International Board-Certified Lactation Consultant) who has worked at PPP since 2005. Through a program of the Georgia Chapter of the American Academy of Pediatrics, she visits physicians’ offices and hospitals throughout the state, training physicians and staff to be breastfeeding advocates. We are pleased to make Joy available for Lactation Consultations. Please call the Front Desk at 404-351-1131 for more information.

Formula Feeding

Always hold the baby. Never prop the bottle in bed or leave the baby unattended while feeding. Burp the baby during and after each feeding. Spitting up is common and should be of no concern.

Infant formula offers a good alternative to breast milk and provides all the nutrients that most babies need the first 4-6 months of life.

As the baby's milk needs grow, the amount offered is increased so that the bottle is just barely emptied or only a little is left.

All formulas may be given to babies as cool as room temperature, depending on the infant's preference, unless otherwise stated by the doctor. The baby may drink from a bottle over a one hour period of time; after one hour the remaining formula should be discarded and a new bottle prepared for the next feeding.

Formula Preparation

Ready Mixed - The individual bottles are opened, any standard sized ring and nipple attached, and the baby is fed. Any milk remaining in the bottle should be discarded. The bottles may be cleaned and reused if you make up a formula, or they may be used for water.

Quart Sized Ready Mixed - The top is cleaned with hot water and soap, then opened with a clean punch can opener. The amount needed is estimated and poured into a clean bottle. The opened can is kept covered in the refrigerator until empty. Discard unused formula after 48 hours. Any formula left in the bottle is discarded, and the nipple and bottle thoroughly cleaned before reuse.

Powdered - Each can of powder contains a small plastic measure. For each level measure 2 oz. of warm tap water is added in a clean bottle. Put the water in the bottle first, then add the powder. The mixture is shaken and is then ready to use.

Concentrated Liquid - The top of the can is cleaned with hot water and soap, rinsed well, and opened with a clean punch can opener. The formula is poured into a clean bottle; an equal amount of tap water is added, the nipple put on, and thebaby fed. The opened can is kept covered in the refrigerator until empty. Discard unused formula after 48 hours. Any formula left in the bottle is discarded, and the nipple and bottle thoroughly cleaned before reuse.

Schedule

Feeding schedules should remain flexible, and the baby allowed to eat when hungry. Breast fed babies commonly feed every 2-3 hours, while formula fed babies go 2 1/2 - 4 hours between bottles. It takes at least two hours for the infant's stomach to empty after eating, so crying less than two hours after the last feeding is seldom due to hunger. Until breastfeeding is well established (3-4 weeks) the baby should be awoken, during the daytime, if he/she remains asleep 3 hours after the beginning of the last feeding. Once the baby is nursing well it is OK to sleep longer during the day, though the more he/she naps during the day, the less sleep there will be at night. After the parents have gone to bed, the infant should be allowed to waken you for feeding.

Skin/Cord/Circumcision

The navel should be kept dry until the cord falls off, usually around two weeks of age. This means not washing the navel with water, and keeping the diaper down low enough so that the wet diaper does not cover the navel. Sponge-bathe your baby with mild soap and water until the cord has fallen off and healed. Some oozing and bleeding from the stump is normal. The cord can be cleaned with an alcohol swab 1-2 times per day. Once the navel has healed, your baby may be put in water for bathing.

If your baby has been circumcised, put some Vaseline on the sore area and cover with a gauze pad at each diaper change. Continue this until the area has healed, usually around one week.

If a diaper rash develops, apply Desitin or Zinc Oxide ointment to the inflamed area at each diaper change and do not use plastic or rubber pants until the rash has healed. Dry skin rashes will be helped by baby lotion applications. Do not use oil or powder on the baby's skin.

Bowel Movements

Bowel movements may vary from as often as following every feeding to as infrequently as every 3-4 days. Even though the baby may strain, unless the stool is hard and pellet-like, he/she is not constipated. It is perfectly normal for a baby to pull his/her legs up, grunt and cry while having a bowel movement. This helps to push the stool out. The color and consistency of the stool may change at times. This is normal. Please call the office if you see blood in the stool.

Vaginal Discharges

Occasionally a light grey, bloody vaginal discharge may be seen in the newborn female. This is a normal occurence. Likewise, the baby's breasts may be swollen for a few weeks, even in males. Massaging the swollen breasts is unnecessary and may be harmful.

Comfort

The temperature of the nursery is right if it feels comfortable to an adult. A baby needs as much clothes or cover as an adult - do not overdress your baby. Your baby's mattress should be firm and level, and no pillow should be used. Fresh air is fine for a new baby. An infant may go out at any age, but exposing the baby to direct sun rays is not advisable.

Swaddling can have many benefits if it is done properly. Because it mimics the comfort of the womb, swaddling can curb crying and promote longer sleep in infants. But if it is done improperly, it can be harmful to the development of a baby's hips.Please visit the following link for more information.

http://www.choa.org/swaddling

Safety

To reduce the risk of SIDS, it is recommended that an infant be placed on his/her back to sleep and that no one smoke in the household. When your baby rides in the car, he/she should be placed in an approved car seat that is properly strapped into the car. Rear facing infant seats should be used from birth until the child is at least 20 pounds and one year old. Your child should remain in a rear-facing car seat until age 2. A rear-facing car seat should not be used in the front seat of the car. Forward-facing seats with a 5 point harness should be used from the time the child is 2 until they outgrow the seats weight/height recommendations. Until 57” or 4 feet 9 in., a booster seat is recommended. At around 8-9 years old and 4’9”, most children are big enough to use an adult seatbelt. Children younger than 13 should not ride in the front seat. Without proper restraint, a seemingly minor accident can lead to tragedy.