Well Child Information - Newborn

Your Newborn

Your Newborn

It is not unusual to hear questions from new parents everyday. How amazing it is to bring a new little member of your family into your home! All parents have many questions about how to care for their new baby. We encourage you to contact our office with all of your questions, no matter how small. We are your medical home, and want to be there for you every step of the way. If we are doing a good job as your pediatrician and teaching you the way we should, eventually you will be able to answer every question yourself. We look forward to discussing with you all of the questions and problems that may arise as your child grows into young adulthood.

By now you have probably noticed many things that seem unique to your baby. Your baby is an individual with unique needs, just as each parent is an individual. In spite of an avalanche of “good advice” from many people, new parents need to realize that none of that good advice is “the answer”. Parents must discover their own way to interact with their baby.


Before 6 months of age, your baby’s digestive system is not developed enough to handle solid foods. Breast milk or an iron-fortified formula is all the nutrition your baby will require until 4-6 months of age. Early introduction of solid foods typically does not help babies sleep through the night and may also increase the risk of allergic reactions and obesity.

Breast Milk - Breast milk is the most nutritious food that you can provide to your baby at this time. It is readily available, provides age appropriate calories and vitamins, and prevents or reduces illness. We like to help nursing mothers, so feel free to call on us. Don’t be surprised if you have a lot of questions or a problem comes up. Together, we can usually solve it easily.

We suggest nursing the baby on demand. This will usually be about 10 - 12 times in a 24 hour period. Your baby will generally nurse frequently (maybe even every hour!) for a few feedings and then he will have a long sleep time. Eventually, breast fed babies typically nurse anywhere from 5-20 minutes per breast every 2-3 hours.

When it is time to nurse, get into a comfortable position with your baby’s tummy against your abdomen. Stroke his cheek with your nipple and when he opens his mouth wide, help him get as much of the nipple as possible.

Watch how your baby is sucking. There are two kinds of sucking; nutritive and non-nutritive. Non-nutritive sucking happens at the beginning of a feeding and will help your milk let down (come out with a good flow). Babies also use non-nutritive sucking at the end of nursing for comfort and pleasure. Nutritive sucking is the “business” part of nursing. Babies suck more slowly, you hear your baby swallowing, and you see milk in the corners of his mouth. Nurse on the second breast for as long as you and he want.

Sore nipples are not uncommon, but can be improved by alternating nursing positions and using correct latch techniques.

How do you know if your baby is getting enough milk? Watch to see that your baby is nutritive sucking, having frequent wet diapers (5-8 a day), and having bowel movements. You may also note that your breasts may feel less “full” after feeds and you may see breast milk in your baby’s mouth. We recommend a weight check in our office at least at 5 days of age for all breast fed babies.

For the first couple of weeks, avoid giving your baby formula. Avoid giving your baby water until he is 6 months old. Once nursing is established, supplemental bottles can be used (We recommend waiting until 3 weeks). Many mothers return to work and continue to nurse. We can talk to you about how to make that transition. Breast fed babies require a vitamin D supplement. Breastfeeding mothers should continue taking a prenatal vitamin.

Formula - As an alternative, you may use any Iron-Fortified formula. Contrary to popular belief, iron does not cause constipation. Typically, a formula fed baby will take approximately 2 to 3 oz. of formula for every pound of body weight, every 3-4 hours (an 8-pound baby will take 16 to 24 oz. over 24 hours). No vitamin supplements are necessary.

If your baby likes to sleep a lot between feedings, wake the baby so there is at least a feeding every 4 hours. The baby needs the security and pleasure of being held at feeding time. Always hold your baby when giving a bottle.

Never use a microwave to warm the formula as this may cause serious burns due to “hot pockets”


Umbilical Cord – There is no need to clean the umbilical cord. The cord usually dries and falls off between 14-21 days. Sometimes there is small amount of blood; this is normal. Give only sponge baths until the cord completely comes off.

Bathing - Daily baths are not necessary; every 2 –3 days is satisfactory. Use only lukewarm water on the baby’s face and a hypoallergenic soap for the rest of the body. Make sure your water heater is kept to less than 120° ° F.

Nails - Keep your baby’s nails short. We recommend using a nail file or blunt nail scissors to trim baby’s nails. Do not use mittens because they will prevent your baby from exploring his environment with his fingers.

Diapers - Change diapers frequently to prevent rashes. Rashes are due to prolonged exposure to urine and/or stool. The new absorbent diapers may feel a lot drier than they actually are. Try to provide a good barrier between the diaper and your baby’s bottom (Vaseline and diaper creams). Avoid talc.

Circumcision - We suggest that your baby be circumcised only if you choose. There is no increased risk of infection for those uncircumcised males who maintain good hygiene techniques. Most decisions to circumcise are made according to social and cultural factors - a family decision.

Vaginal Discharge - Girls often have a slight clear or cloudy discharge from the vagina; that is normal. Also normal is slight vaginal bleeding that starts around the seventh day and lasts 2 or 3 days.

Health and Safety

SIDS – We recommend that babies sleep on their backs, in their own bed, in order to decrease the incidence of Sudden Infant Death Syndrome (SIDS). There is a 75% decrease in SIDS for those infants sleeping on their backs. You can further decrease the risk by breastfeeding, using a pacifier during sleep, running a fan in the baby's room, having the baby's bed in your room, and by having no smoking in the home. We recommend swaddling the baby. Sleeping on the back may cause some flattening of the back of the head. You may want to have your baby's head facing one direction for a few nights, then the other direction for a few nights. This will help keep your baby's head rounded instead of flat.

Sleeping on the back may cause some flattening of the back of the head. You may want to have your baby’s head facing one direction for a few nights, then the other direction for a few nights. This will help keep your baby’s head rounded instead of flat.

Infection - Babies have immature immune systems. Going outside is NOT dangerous, but exposure to large numbers of people should be avoided (such as shopping malls). Other than siblings, exposure to children and ill adults should be limited. It is best to limit exposure until your baby is 2 months old.

The best way to prevent illness is through thorough hand washing either with soap and water, or a hand sanitizer like Purell. Call the office immediately for temperatures greater than 100.4° ° rectally. Do not give any medicines without speaking with our office first.

Smoking - Smoking around the baby, or smelling like cigarette smoke, can increase your baby’s risk of asthma, sinus infections, ear infections, SIDS, and other respiratory illnesses. One of the best “gifts” you can give your baby is to stop smoking.

Chairs/Cribs - Never leave your baby unattended on a table, couch, bed, or other elevated surface. Make sure that crib slats are no more than 2-3/8” apart on your crib. To decrease the risk of suffocation, do not put pillows, stuffed animals, bumper pads, or extra blankets in the crib. When traveling in a car, never have the baby in your lap. Use only an approved rear-facing infant car seat that is placed in the middle of the rear seat.

Warning Signs - You should call us if you think your baby is sick. Some warning signs in the first month are:

  1. A temperature over 100.5° ° when taken rectally
  2. Refusal to nurse or take a bottle
  3. Repeated vomiting
  4. Not urinating at least every 8 hours
  5. Being very restless and irritable
  6. Difficult to wake up at feeding time
  7. Looking sick, or “just not right”

Advance Preparation - You may find it convenient to purchase in advance from your drug store: a rectal thermometer, liquid acetaminophen (Tylenol), a cool mist vaporizer, and infant nasal aspirator. Check with us before administering any medications.

Development and Behavior

All newborns will cry and cough, pass gas, have hiccups, burp loudly, yawn and sneeze. Babies sneeze because it is the only way they have to clear the nose of mucous or milk. Hiccups are spasms of the diaphragm muscle, which are not dangerous. You may have noticed that your baby even hiccupped while inside you. Most babies do not usually mind having hiccups.

All babies cry and with time you will be able to determine whether the baby is saying “I am hungry”, or “I am cold”, or “I have a stomach ache”, or “I am bored”. An occasional cough is the baby’s way of clearing his throat.

Motor Skills - A baby’s nervous system develops from the head down to the toes. You will notice this progression over the next several months. For now, your baby will be able to turn his head from side to side and may even be able to hold his head up. Your baby will have poor control of his hands and probably does not even know that they are part of his body.

Vision – A baby will be aware of light and dark borders. He may briefly look at a person’s face and follow light or bright objects. He typically does not smile socially until close to 8 weeks. You may see smiles of “contentment” before that time.

Hearing - Babies will react to loud noises by startling, but may also be calmed by a quiet voice or song. Babies need to be held, cuddled, and loved. A baby under 6 months of age cannot be spoiled.

Fussiness - Many babies have a crying or fussy period lasting from 10 minutes to 4 hours each day. Occasionally, babies will have more than one fussy period a day. Most fussy periods tend to occur late in the afternoon and early evening. Crying is your baby’s way of communicating. It does not always mean that your baby is hungry. Your baby will cry to be fed, to be held, to go to sleep, and to play. Babies who are responded to, tend to eventually cry for shorter periods of time. Carrying your baby helps to establish trust, prevents SIDS, and helps to prevent flat heads. The time not to respond to your baby is that time when you are feeling frustrated and angry. Let someone else take a turn at meeting your baby’s needs. NEVER SHAKE YOUR BABY.

Sucking - Some babies require more sucking in the first few months than others. Sucking does not necessarily mean that your baby is hungry. Thumb sucking and pacifiers are not harmful, but they do have their advantages and disadvantages. In general, look for a one-piece, solid pacifier with a large mouth guard. Do not tie a pacifier around your baby’s neck.

Spitting-Up - Some spitting-up is normal. It always looks worse than it actually is. Apart from being messy, there is usually no cause for concern unless your baby has poor weight gain or is overly irritable. Spitting-up does not indicate a need to change formulas. To minimize spitting-up, feed your baby in an upright position, burp your baby frequently, and try to keep your baby upright for 15 to 20 minutes after each feeding.

Bowel Movements - Many infants appear to have difficulty passing even soft stools. Straining, turning “red in the face”, and infrequent stools are all part of normal intestinal development. All babies have their own bowel patterns, ranging from one with every feeding to one every several days. By definition, constipation refers to the “hardness” of the stool, not the frequency. Straining with bowel movements does not indicate the need for a formula change.

Sleep - The amount of sleep each infant requires varies a great deal. Typically, a newborn will sleep a total of 14-20 hours a day. This total amount of sleep may randomly be divided into anywhere from eight 2-hour periods to four 4-hour periods. You can help a baby realize that it is sleep time by keeping your baby in a quiet room with minimal activity at night, and in a more active area of the house during the day.

Next Visit is the 2 Week Checkup

At your baby's 2 week visit, look forward to receiving more information on: Breastfeeding, Shaken Baby Syndrome, and Finding Childcare. Contact us if you would like information sooner.

Contact us today to find out more about our practice!

Address: 809 E. Ridge Road, Rochester, NY 14621  |  Phone: 585-266-0310  |  Fax: 585-266-9207

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