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Hospital Newborn

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Congratulations on the birth of your newborn baby! We look forward to getting to know you and your infant and partnering with you to raise a healthy child. While you are in the hospital, one of our pediatricians will visit you and the baby daily. In the hospital, your baby may receive the hepatitis B vaccine, a hearing test and have a blood test for a variety of inherited metabolic diseases. Call our office to schedule a first visit for your baby within 2-3 days after hospital discharge. We will discuss with you if we want to see your newborn earlier.

Feeding

We encourage breastfeeding! It may take 2-4 days for your milk to “come in.” Babies are born with some extra fluid, and it is normal for them to lose weight for the first week in this transition period. Try offering the breast for 10-30 minutes every 2-3 hours (8-12 feedings per day). Sometimes the baby will be sleepy at first – if he is difficult to rouse, try to wake the baby up by removing clothes, tickling his feet and even applying a cool washcloth to his head or feet. It also can be normal for the baby to “cluster feed,” or feed very frequently every half to one hour for a stretch of time. It is helpful for us and for you to keep a diary of when the baby eats, stools, and urinates. Bring this in for the first visit – this helps us to determine if the baby is eating adequately. There is a learning curve for most moms and babies for breastfeeding. Don’t get discouraged – the majority of problems with breastfeeding can be solved. We are here to help you – call us if you have any questions, or if your baby will not feed at least every 4 hours. We have lactation specialists available for consulting both in the office and in the home.

If you are bottle feeding, use an iron-fortified infant formula. Feed your baby between 1-3 ounces every 2-4 hours. It is okay to use tap water to mix powdered or concentrated formula. Babies do not need supplemental water. It is normal to have a slight coating of milk on the tongue. This is not harmful.

Elimination

The initial stools that a baby passes are typically black and sticky and are called meconium. After the first day or two, they will change and become dark green and then change to variable colors of brown, yellow or green. Call us if they are red or contain lots of mucus. Stools will gradually increase over the first week and may be as often as 8-10 times a day or with every feed.

Urine will also gradually increase as the baby starts to eat more. The rule of thumb we use is to see one wet diaper per day of life. A baby may only have 2-3 wet diapers per day when you leave the hospital but will increase to 6-7 wet diapers by the end of the first week. Diapers are very absorbent now so it can be hard to tell if the baby has urinated. One trick if you are not sure is to put a piece of tissue paper inside the diaper.

Sleep

Newborn babies sleep a lot, as often as 18 hours a day. The first 24 hours of life is often an especially sleepy period – they are also tired from the delivery! Initially they will be more alert during the night and more sleepy during the day. This will gradually improve but this may take several months. Be patient; try to take naps and sleep when the baby is sleeping. Your sleep deprivation will add up, so you need to take care of yourself. Accept help from others.

Your baby should sleep on his back on a firm surface. We recommend cribs or bassinets. Don’t put any pillows, toys or blankets in the bed. If you must co-sleep, minimize the risk of sudden infant death syndrome (SIDS) by making sure no one in the bed has been drinking or smoking, and keep all blankets away from the baby.
Your baby is too young to “sleep train.” When the baby cries it is generally to communicate something to you. You are not spoiling your baby by holding him frequently.

Baby Care

The umbilical cord stump typically falls off between 1 and 4 weeks of age. It is similar to a scab and does not hurt the baby as it comes off. The newest recommendation is to leave it alone and not clean it with anything – nature has designed it to take care of itself. If it gets dirty or is oozing, clean it gently with a cotton ball with water or alcohol. Sometimes as it separates there may be a few drops of blood – this is nothing to worry about. Call us if, after it falls off, the umbilical area remains moist, oozes or has a bad odor.

Give sponge baths with a warm wet washcloth until the cord has fallen off. You may use a tub bath once the cord has fallen off. Use mainly water and a small amount of a sensitive-skin baby wash in the bath. Johnson’s baby wash has a scent and sometimes irritates sensitive skin. You may use an unscented sensitive skin ointment or cream on their skin if it is dry or flakey.

Unscented sensitive-skin diaper wipes are fine for cleaning the diaper area. You may also use soft wet towels to clean the diaper area. If the diaper area becomes red and irritated, use a thick coating of an unscented diaper rash ointment.

Female babies may have a vaginal mucus discharge, at times with a slight amount of blood. This is stimulated by the mom’s estrogen hormones and will gradually decrease. Clean the genital area gently from front to back.

After a circumcision, the baby’s penis will look red and raw. To protect it and help it heal you will be using a gauze dressing with petroleum jelly over it. Continue the petroleum jelly dressing until the skin looks pale pink and healed, usually about a week.

It is normal for newborns to sneeze frequently, sound congested, hiccup a lot, make squeaky noises when they sleep and startle easily. If your baby is coughing frequently or seems to be working harder to breathe, call our office.

Babies have less body fat than parents, so check to make sure they feel warm. They often need one more layer of clothes than their parents.

The newborn period is amazing and exciting but is also exhausting. Let people help you and try not to do too much. Call our office or your OB if you think you may be experiencing postpartum depression or the “baby blues.”

Call our office if the baby has a fever over 100.4 rectally (buy a digital thermometer and use it rectally to check for temperatures if the baby feels warm). Call also if the baby is repeatedly vomiting (more than just spit up), has diarrhea, looks yellow through the trunk/chest area, or fails to wake up and feed at least every 4 hours. Don’t be afraid to call us – we are available for your questions 24 hours a day, 7 days a week.

Additional Resources

Our Providers

  • Dr. Cathy DiVincenzo Dr. Kathy Shepherd
  • Dr. Adam Aronson Dr. Elana Comrov

Our Nurse Practitioners

  • Jean Kopp, CPNP
  • Stephanie Brennan, FNP-C
  • Karen Gentile, CPNP