NEWBORN CARE

 

These notes are intended to be a brief reminder of a few things that a newborn child may have or may need.

FEEDING: Newborn babies need only breast milk (best) or formula (also acceptable) for the first year. Generally we prefer allowing the baby and mother to establish a schedule as they prefer rather than setting a definite time period between feedings.  Breastfeeding moms may use a little lanolin in caring for their nipples.  We can suggest a lactation consultant if needed. Be sure your diet is adequate and include plenty of milk. If you're bottle feeding, any of the major brand milk-based formulas are suitable.  Bottle fed babies should be on iron-fortified formula.  Babies don't need extra water except in a hot climate. If you're having feeding problems, please feel free to call the Clinic.

VITAMINS, IRON AND FLUORIDE: Breast milk lacks an ideal amount of vitamin D for newborns.  Breast fed babies need a supplement of 400 IU of vitamin D daily.   Vitamin D can be supplemented in an infant multivitamin.  Formula has added vitamins.  At about six months we may suggest a source of iron, such as infant cereal, for babies. Depending on where you live and how much water the baby is getting as she or he gets older, we may suggest fluoride after the first year.

SLEEPING: Healthy babies should sleep on their back in a firm bassinette or other secure space. Sleeping on the tummy is not recommended. Propping the baby on his or her side is acceptable, but there is the risk the baby will roll onto the tummy. Feeding in bed with the parent is fine, but babies should sleep in a defined area on the bed or next to the bed if the parents don't want to get up to place the infant in a bassinette.

UMBILICAL CORD CARE: The cord should dry and fall off at between a week and three weeks of age. Clean the cord stump area with rubbing alcohol on a cotton ball or Q-tip three or more times a day. Don't be afraid to lift the cord up and clean underneath it.  Chlorhexidine (Hibiclens or generic) is slightly better than alcohol for cord care.

BATHING: Newborns don't require a great deal of bathing. A sponge bath or bath in warm water in a warm room is appropriate for the first month or so. These should be given several times a week, but not necessarily daily. Try not to soak the umbilical cord during the first few weeks of life. If desired, a baby soap or shampoo can be used.  No baby oil, cream or diaper ointment is necessary, but many parents like to use A&D, Desitin or other diaper preparation with no fragrance and few ingredients.

JAUNDICE: Jaundice is yellowness in the skin caused by the breakdown of blood to bilirubin and the inability of the liver to pick it up and change it to bile rapidly.  Yellowness in the face in the first week is OK.  If this gets progressively worse at home, call the Clinic to check a bilirubin at the laboratory.

RASHES: Most babies get mild rashes during the first few weeks of life. These generally require no specific treatment, but if there are blisters or a raw or weeping area involved, you should let us know.

NOISY BREATHNG: A "rattle in the chest" or " bubbling" with breathing is often heard with newborns because of the small airway. Usually simply changing positions will change the noisy breathing. If the newborn is consistently breathing more than 60 times a minute or if there is a runny nose or fever, you should let us know.

Dr. Spock's book, now updated by Dr. Robert Needlman, -Baby and Child Care - is still generally an excellent reference for many problems.   Also Caring For Your Baby and Your Young Child - by the American Academy of Pediatrics, is very useful, too.

Depending on the babyıs age and/or history in the hospital, we like to see newborns at the Clinic from a couple of days to two weeks after discharge.  Please call the Clinic for an appointment well ahead of the time your baby needs to be seen.

If you have further questions about any of the above or other problems, please call and talk with one of us.

Ted Humphry, M.D. 
 for McKinleyville Community Health Center Pediatrics      839-2677

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this information last updated 01/09