Newborn Check-up

(Children up to 2 Weeks Old)

Feeding: Breastfed babies usually nurse for 10-30 minutes every 2-4 hours. Bottle fed babies average 2-3 ozs every 3-4 hours. Cereal, baby food, or extra water is not needed at this age. Do not give regular cow’s milk or prop the bottle. If you are exclusively breastfeeding or supplementing with less than 17 ounces of formula per day, your newborn will need to start a vitamin D supplement. He/she will need 400 IU of Vitamin D a day. There are several brands of infant vitamins that are available over the counter that meet this recommendation.

Sleeping and Prevention of Sudden Infant Death Syndrome: Babies at this age have no sense of night or day yet. By 6 weeks, some babies may sleep 5-6 hours straight at night. Try to sleep when your baby does. Always place your baby on his/her back to sleep. This has been shown to reduce the incidence of Sudden Infant Death Syndrome. Tummy time is recommended several times a day, but only when you and your child are awake. 20% of SIDS deaths occur in childcare. Please insist that you daycare places your child on his/her back to sleep. Select a crib that conforms to the Consumer Product Safety Commission recommendations. If your crib was built after 1981, it should have met the proper recommendations. Check and periodically recheck the crib to assure that there are no loose, broken or sharp parts. Select a firm, snug-fitting mattress, and never put a baby to sleep on a waterbed, sofa, soft mattress, pillow or other soft surface. Use light clothes for sleep and keep the room at a temperature comfortable for an adult (around 75 degrees) to avoid overheating. Do not put comforters, pillows, sheepskins, crib bumpers, or stuffed animals in the infant’s crib.

Bowel Movements: Breast fed babies may have stools each time they feed, but they may have one stool every 2-3 days. Formula-fed babies average a stool every third day to 3-6 per day. Almost all babies turn red and grunt and strain when pooping. This doesn’t always mean they’re constipated. Formulas with iron usually do not cause constipation. If baby’s stools are hard and painful, talk to your doctor. Avoid suppositories as the first treatment.

Development: Babies can see and hear but they also spend a lot of time sleeping. Newborns usually spend about 16-20 hours per day sleeping. A newborn can see about 12 inches, but cannot focus well yet.

Bathing: Make sure you bathe your baby in a safe place, like the sink or plastic tub. Babies don’t need baths every day, and not before the cord falls off. You can use a sponge or washcloth to gently clean the baby until then. Never leave a baby alone in water. Turn the hot water heater down to 120° F or to the setting marked “low” if the temperature is not listed on the hot water heater. This will help prevent accidental burns. At higher water temperatures, a baby’s skin can burn in less than a second. At lower temperatures (120°), it takes a lot longer to burn and this will give you more time to react if hot water gets on your baby.

Cord care: Clean baby’s cord with rubbing alcohol once per day if needed, otherwise, you do not have to put anything on it. If there is drainage once the cord has fallen off, you can continue this for 2-3 days after. You may see a small amount of blood after the cord falls off and this should dry up on its own within a few days.

Colic: Colic is a word for crying spell, especially in the evening, when baby may be hard to comfort. Occasionally they cry so hard they appear to be in pain, but when examined no cause can be found. Help your baby by not overreacting. Try swings, car rides, rocking, swaddling, or music. See your doctor to make sure there is nothing else wrong. Don’t switch formulas without talking to your doctor. Try to be patient and get help. Never shake a baby.

Illness: In babies less than 2 months, any fever needs a call and a visit to the doctor or ER. Anything 100.4°F or higher is a fever. The temperature should be taken with a rectal thermometer; other methods of taking temperatures at home are less reliable in newborns. Try not to expose your baby to sick people or groups of people at this age. Most babies will miss a feeding every now and then, but missing 2 in a row is abnormal. If this happens, wake your baby and try to feed. If your baby will not eat, that is abnormal and you should call or seek medical care. Also, if you think your baby is not acting right, you should call your doctor. Parents are often able to pick up on subtle signs of illness before doctors or nurses, because they know their child so well.

Safety: Make sure you have working smoke detectors in the house, especially in children’s rooms. Make sure to check the batteries monthly and to change the batteries at least twice a year. Keep your child in the infant car seat at all times when the car is moving. If your child is fussy and wants to be held, do not take them out of the car seat unless you pull over first. Babies in car seats should not be placed in the front passenger seat, especially if there is an air bag. All car seats are different, please read the manual to assure yours is appropriate for your child’s age and weight, and to assure that you install it properly.

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For additional information the American Academy of Pediatrics has a website with general information: www.heathychildren.org

Your next appointment will be at 2 weeks old.