You’re home from the hospital with your newborn and finally settling into a routine. But you have questions, lots of questions that never popped into your head until this tiny person was in your arms.
Lisa Hainstock, MD, wants parents to understand that no question or concern is too insignificant for your pediatrician.
We asked Hainstock some of the most common questions she gets from new parents.
When should parents call the doctor?
If there are concerns, parents should have no hesitation about calling the pediatrician.
Otherwise, call if the baby:
- Has a fever of 100.4 or higher
- Is excessively fussy or lethargic
- Isn’t feeding well
- Has a decrease in wet diapers
What is a normal feeding schedule like?
There is no normal feeding schedule. I tell parents to aim for eight to 12 feedings a day. But a lot of parents think their baby should feed every three hours. Many parents think their baby should feed every three hours by a clock, but more often than not, they are on their own schedule.
If the parent is waking the baby up to eat by a schedule, it may result in a poor feeding, and both will be unhappy.
How do you know if the baby’s eating enough?
In the first week of life, we go by this rule: The number of wet diapers should equal the number of days of life. So 3-day-old babies should have three wet diapers in 24 hours. During those first days, the baby is learning to eat. It also takes some time for the mother’s milk to come in if she is breastfeeding.
After the first week, the baby should have seven or more wet diapers a day. That’s a good indicator the baby is well hydrated.
What’s a typical weight loss after birth? When will the baby start gaining weight?
We don’t want to see the weight drop by more than 10 percent. Three to 10 percent is typical. If the baby has excessive weight loss, we may need to look at other feeding strategies.
Most babies are back to their birth weight by 10 to 14 days of life. Some signs and symptoms are considered emergencies, including:
- Green vomit
- Excessive vomiting
- A firm and distended abdomen
Parents should call the pediatrician right away if they notice any of these, as it may indicate a surgical emergency. A blockage of the intestines is rare but important to recognize early.
Why is the baby spitting up so much?
100 percent of babies have reflux. The area between the stomach and the esophagus isn’t strong enough to keep the food in when they’re newborns. This often resolves by six months to a year.
As long as the baby is gaining weight, it’s not typically concerning. If you think it’s excessive, you should discuss it with your pediatrician.
How often should the baby be pooping?
It really varies. Some poop eight to 10 times a day; some only every other day. As long as they’re eating and gaining weight, don’t focus on the number.
What about poop color? Is it important?
Don’t worry about the poop color unless it’s overtly white or has blood or mucus. All shades of green, brown and yellow are normal.
Should we be concerned about this rash?
There are so many infant rashes, and the vast majority of them are benign. Parents shouldn’t hesitate to call the pediatrician if they’re concerned. Definitely call if the rash is tender, associated with a fever or excessive fussiness, or there are fluid-filled blisters.
With diaper rash:
- Use an ointment with zinc.
- Keep the baby’s diaper off if possible.
- Limit using soaps and wipes with perfume. If the rash is especially bad, use warm water and a soft cloth instead of wipes.
- Stay on top of diaper changes — check every two hours if the baby is awake.
The baby bumped her head. Is this serious?
It’s worthwhile to call the pediatrician for any fall involving a head bonk or injury. The pediatrician will likely want to know the method of injury and how the child is behaving. A fall from sitting on the carpet is probably OK, whereas a fall from a bed onto a hardwood floor could result in a more serious injury
We get concerned if the baby lost consciousness, is vomiting or is excessively fussy or sleepy.
If the baby’s crying for no obvious reason, how long should we wait before getting concerned?
If your baby is crying and inconsolable for a long period of time, call the pediatrician. It could be something benign like colic or reflux, but it may represent something more serious, such as an infection.
How do we take care of and clean the umbilical cord area?
Less is more in taking care of the umbilical cord. We do not recommend alcohol wipes to the area anymore. Keep the area as dry as possible. Only give sponge baths until the cord falls off. After that, it’s fine to give the baby a regular bath.
Find a Pediatrician
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How should we dress the baby? Should she be warm or cooler?
The best advice I can give is to dress the baby the way you are dressed. If you are comfortable, the baby likely is as well.
