When you bring home baby, there are a lot of things to know right away — we understand it can be a little overwhelming at first.
Newborns have many needs, like frequent feedings and diaper changes. Babies can have health issues that are different from older children and adults, like diaper rash and cradle cap.
Your baby will go through many changes during the first year of life. You may feel uneasy at first. Ask your health care provider for help if you need it.
Listen in as Beth Summers, MD discusses the best ways to take care of your newborn and the signs to watch for that might signal a call to the pediatrician.
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Caring For Your Newborn
Featured Speaker:
Learn more about Beth Summers, MD
Beth Summers, MD
Beth Summers, MD is a Pediatric Hospitalist at Hendricks Regional Health.Learn more about Beth Summers, MD
Transcription:
Melanie Cole (Host): When you bring home baby, there are a lot of things to know right away and we understand it can be a little overwhelming at first. My guest today is Dr. Beth Summers. She's a pediatric hospitalist at Hendricks Regional Health. Welcome to the show, Dr. Summers. What do you tell new parents that day that they're leaving the hospital, some of the most important things you want them to know about bringing home new baby?
Dr. Beth Summers (Guest): I think, in general, I go over just basic care of their newborn. So, like how many wet diapers they should have, what their stools should look like--because the baby stools go to a varied transition from their first stools are called meconium which are black in character; and then, they transition to a greenish color; and then, the final transition that the newborn stools go into is a yellow, seedy color, where they actually might look like they have sesame seeds in their stool and sometimes this is very surprising to new parents. So, the major thing that I go over is just generalized care. So, for example, a baby should have at least one wet diaper for every day old they are. So, for example, if they're two days old, they should have at least two wet diapers a day; if they're three days old, at least three; and then, after a week of age, that changes. They'll have 6-10 wet diapers a day and that's normal. As far as the baby poops, they can have a little baby poop after every feeding, once or twice a day. They're going to find their own stool pattern. What I consider constipation and when parents should seek help from their pediatrician and go to the doctor, is when the poops come out like rock-hard marbles, that's a sign of constipation in their newborn. Then, I go over some daily feeding care. Whether you're breastfeeding or you're bottle feeding your baby, normally babies, if they're breastfeeding, feed up to 8-10 times a day, sometimes more. Usually every two to three hours. We try to tell parents not to go longer than three hours between breast feeds. We talk to moms about drinking a lot of water, if they like oatmeal, that will also help their milk come in, and we provide supportive lactation services for those new moms to get their milk supply in. For those moms that decide to give nutrition to their babies through formula feeding, we give similar advice about feeding their baby every three hours and taking anywhere from 15 mls, which is about a half an ounce, to an ounce-and-a-half, which is 45 mls, at a time and any time a baby received nutrition through either expressed milk through the bottle or formula through a bottle, they swallow a lot more air, so those babies need to be burped halfway between a feeding and then after a feeding. Kind of held upright a little bit, so their tummy has time to digest their food. So, some basic things that I go over are basically, you know, what kind of you know, output should a baby have in their wet and their poopy diapers, and then how do you feed their baby. Then, I also receive a lot of questions from parents about how to take care of the umbilical cord. There's been a transition in how we take care of that umbilical cord. Before, it used to be recommended to use alcohol to dry the cord. That is no longer the recommendation, because it's been actually found to delay the cord from falling off and is very drying to the surrounding skin and can cause skin breakdown. So, now what we counsel the parents to do is just let the cord dry by air. It usually falls off between 10-14 days of life. Until that cord falls off, just kind of sponge your baby every couple of days to keep them clean.
Melanie: Then, what about taking baby home as far as cribs go? Where do you want new baby to sleep?
Dr. Summers: So, we want them to sleep alone and in their own bed and bassinet on a hard surface--so a mattress that just has a sheet on it. No bulky blankets or anything in the crib. They can sleep on their back, that's been shown the safest to prevent Sudden Infant Death Syndrome. So, in their own crib, on their back, and no bumpers, or bed padding that protects the rails within the crib because those kind of can fall on the baby where the baby gets, as they get a little older, they can move towards the side and actually suffocate themselves against the crib padding. So, basically, just a single sheet; lay the baby in the middle of the crib or bassinet. They can be in a swaddler.
Melanie: So, what do you tell them about swaddling?
Dr. Summers: Actually, they can swaddle for the first six weeks. That's perfect. We actually demonstrate the swaddling in the hospital here that I work at, and we actually provide them with swaddlers for home use when they go home with their baby. Really, a baby just needs a onesie, or you know, whatever outfit you want, and then you can put them in their swaddler and put them on their back to sleep. That's all you really need to do.
Melanie: And, before we even get the baby home, what do you tell them about car seats?
Dr. Summers: Car seats? So, always in the backseat, rear-facing, up to 40 pounds. We actually have car seat inspectors/technicians at our hospital. Most hospitals do that now where we inspect all the car seats to make sure there's no recalls on that individual car seat that the family brings in. We will actually do a car seat fitting. We'll make sure that shoulder straps and chest straps to secure your baby in the car seat are at the appropriate height and we demonstrate to the family how that's done. We will actually also fit the car seat and make sure that it's balanced in the back of the car to make sure that everything is appropriately set up for that family when they take their newborn home.
Melanie: Such important information. Now, one of the things that parents kind of get a little bit nervous about is crying and babies cry. What do you tell them about crying and when do you say, “Well, it might be a little gastrointestinal distress or colic?”
Dr. Summers: Sure. So, first of all, crying is a natural way of communicating to the parents. So, babies cry for several reasons. One, they just want to be held. You can't spoil a newborn. You can spoil a two-year-old or a three-year-old, but not a newborn. Number two, they cry because they've got a dirty diaper and they don't like sitting in that wet environment. Number three, why they cry is they are hungry. That's a way of communicating to us that they're hungry. Very rarely does a baby cry because they're in pain. It's usually because they just want to be held and loved; they want to have that interaction with their mommy and their daddy or parents; and they want to just be make sure that they're pants are kept dry and fed. Very rarely do they cry. Colic usually doesn't present until like closer to two months of age, so those babies that present with excessive crying at that time can be due to belly issues in their child, but usually that doesn't present until later. The newborn period is mainly they want to be held, they want to be fed, they want to have dry pants. Very rarely do they cry because they're in pain.
Melanie: What advice do you give parents about dealing with that crying and not getting stressed out themselves because of it?
Dr. Summers: Well, actually we play something called “The purple crying video” that goes over what do you do with a crying baby? You can make sure that if you have reached your limits as far as you're getting a little anxious in what to do with a crying baby. I tell parents to safely place their baby in a crib or bassinet, where they're in a safe place, and just take a break. Just step away for a little bit. And, if you have a partner that can help you take over that stress while you just need a moment to recollect your thoughts and just need a break for a little bit, that's okay. You know, babies can cry. That's okay. They're not going to hurt themselves or anything by crying, but if you need that moment where it's just getting overwhelming for you as a new parent and you need a little break, know when to ask for help if you have a support person or a friend or a grandparent that "Hey, I need a break. I need to take a break for myself," that's completely okay. It happens to everybody. So, I just tell them to make sure that if they get overwhelmed and they're dealing with a crying baby and they've tried the feeding and the holding and, you know, changing the diaper, and they don't know what to do, either just take that break, give it a little chance to see if the baby will settle down, or if they feel that something's wrong with their baby, then call their doctor to figure out what the next step to help that baby feel better.
Melanie: So, wrap it up for us about newborn care, what you tell parents every single day about taking their baby home, why it's so exciting, and why they should come to Hendricks Regional Health for their care.
Dr. Summers: Well, I'm one of the pediatric hospitalists. We have three other partners. I think we provide very superb care with our nursing staff and our partners without OB physicians. I think we all work as a well-oiled machine and we have different experiences and even in our own lives whether we've built our families through adoption or have our own families naturally, I think we all work very well together in making sure a parent is very comfortable in taking their newborn home. We do education in the hospital. We have a newborn cares video that we go over basically anything you want to know about a newborn whether it's changing their diaper, or umbilical cord care, or safe sleep, or what kind of immunizations they should get before discharge, or why a Vitamin K injection is important for preventing head bleeding in babies. We try to make sure a parent is well-prepared and not only do they hear this from a physician perspective, but our nurses are trained also to give the same education. We provide the newborn cares video that we've made for our hospital, and the purple crying video which about how to soothe a crying baby appropriately without harm. We give a copy to each family to take home and use as reference. And then, we make ourselves available. We tell them if they have any questions about their newborn and they haven't established their pediatrician yet, or haven't seen their pediatrician for the first time, we know they're a newborn and we would be more than happy to answer any questions that they might have, even if it's in the middle of the night, to make sure that they get the greatest start for their family.
Melanie: Thank you so much, Dr. Summers, for being with us. You're listening to Health Talks with HRH, Hendricks Regional Health and for information, you can go to www.hendricks.org. That's www.hendricks.org. This is Melanie Cole. Thanks so much for listening.
Melanie Cole (Host): When you bring home baby, there are a lot of things to know right away and we understand it can be a little overwhelming at first. My guest today is Dr. Beth Summers. She's a pediatric hospitalist at Hendricks Regional Health. Welcome to the show, Dr. Summers. What do you tell new parents that day that they're leaving the hospital, some of the most important things you want them to know about bringing home new baby?
Dr. Beth Summers (Guest): I think, in general, I go over just basic care of their newborn. So, like how many wet diapers they should have, what their stools should look like--because the baby stools go to a varied transition from their first stools are called meconium which are black in character; and then, they transition to a greenish color; and then, the final transition that the newborn stools go into is a yellow, seedy color, where they actually might look like they have sesame seeds in their stool and sometimes this is very surprising to new parents. So, the major thing that I go over is just generalized care. So, for example, a baby should have at least one wet diaper for every day old they are. So, for example, if they're two days old, they should have at least two wet diapers a day; if they're three days old, at least three; and then, after a week of age, that changes. They'll have 6-10 wet diapers a day and that's normal. As far as the baby poops, they can have a little baby poop after every feeding, once or twice a day. They're going to find their own stool pattern. What I consider constipation and when parents should seek help from their pediatrician and go to the doctor, is when the poops come out like rock-hard marbles, that's a sign of constipation in their newborn. Then, I go over some daily feeding care. Whether you're breastfeeding or you're bottle feeding your baby, normally babies, if they're breastfeeding, feed up to 8-10 times a day, sometimes more. Usually every two to three hours. We try to tell parents not to go longer than three hours between breast feeds. We talk to moms about drinking a lot of water, if they like oatmeal, that will also help their milk come in, and we provide supportive lactation services for those new moms to get their milk supply in. For those moms that decide to give nutrition to their babies through formula feeding, we give similar advice about feeding their baby every three hours and taking anywhere from 15 mls, which is about a half an ounce, to an ounce-and-a-half, which is 45 mls, at a time and any time a baby received nutrition through either expressed milk through the bottle or formula through a bottle, they swallow a lot more air, so those babies need to be burped halfway between a feeding and then after a feeding. Kind of held upright a little bit, so their tummy has time to digest their food. So, some basic things that I go over are basically, you know, what kind of you know, output should a baby have in their wet and their poopy diapers, and then how do you feed their baby. Then, I also receive a lot of questions from parents about how to take care of the umbilical cord. There's been a transition in how we take care of that umbilical cord. Before, it used to be recommended to use alcohol to dry the cord. That is no longer the recommendation, because it's been actually found to delay the cord from falling off and is very drying to the surrounding skin and can cause skin breakdown. So, now what we counsel the parents to do is just let the cord dry by air. It usually falls off between 10-14 days of life. Until that cord falls off, just kind of sponge your baby every couple of days to keep them clean.
Melanie: Then, what about taking baby home as far as cribs go? Where do you want new baby to sleep?
Dr. Summers: So, we want them to sleep alone and in their own bed and bassinet on a hard surface--so a mattress that just has a sheet on it. No bulky blankets or anything in the crib. They can sleep on their back, that's been shown the safest to prevent Sudden Infant Death Syndrome. So, in their own crib, on their back, and no bumpers, or bed padding that protects the rails within the crib because those kind of can fall on the baby where the baby gets, as they get a little older, they can move towards the side and actually suffocate themselves against the crib padding. So, basically, just a single sheet; lay the baby in the middle of the crib or bassinet. They can be in a swaddler.
Melanie: So, what do you tell them about swaddling?
Dr. Summers: Actually, they can swaddle for the first six weeks. That's perfect. We actually demonstrate the swaddling in the hospital here that I work at, and we actually provide them with swaddlers for home use when they go home with their baby. Really, a baby just needs a onesie, or you know, whatever outfit you want, and then you can put them in their swaddler and put them on their back to sleep. That's all you really need to do.
Melanie: And, before we even get the baby home, what do you tell them about car seats?
Dr. Summers: Car seats? So, always in the backseat, rear-facing, up to 40 pounds. We actually have car seat inspectors/technicians at our hospital. Most hospitals do that now where we inspect all the car seats to make sure there's no recalls on that individual car seat that the family brings in. We will actually do a car seat fitting. We'll make sure that shoulder straps and chest straps to secure your baby in the car seat are at the appropriate height and we demonstrate to the family how that's done. We will actually also fit the car seat and make sure that it's balanced in the back of the car to make sure that everything is appropriately set up for that family when they take their newborn home.
Melanie: Such important information. Now, one of the things that parents kind of get a little bit nervous about is crying and babies cry. What do you tell them about crying and when do you say, “Well, it might be a little gastrointestinal distress or colic?”
Dr. Summers: Sure. So, first of all, crying is a natural way of communicating to the parents. So, babies cry for several reasons. One, they just want to be held. You can't spoil a newborn. You can spoil a two-year-old or a three-year-old, but not a newborn. Number two, they cry because they've got a dirty diaper and they don't like sitting in that wet environment. Number three, why they cry is they are hungry. That's a way of communicating to us that they're hungry. Very rarely does a baby cry because they're in pain. It's usually because they just want to be held and loved; they want to have that interaction with their mommy and their daddy or parents; and they want to just be make sure that they're pants are kept dry and fed. Very rarely do they cry. Colic usually doesn't present until like closer to two months of age, so those babies that present with excessive crying at that time can be due to belly issues in their child, but usually that doesn't present until later. The newborn period is mainly they want to be held, they want to be fed, they want to have dry pants. Very rarely do they cry because they're in pain.
Melanie: What advice do you give parents about dealing with that crying and not getting stressed out themselves because of it?
Dr. Summers: Well, actually we play something called “The purple crying video” that goes over what do you do with a crying baby? You can make sure that if you have reached your limits as far as you're getting a little anxious in what to do with a crying baby. I tell parents to safely place their baby in a crib or bassinet, where they're in a safe place, and just take a break. Just step away for a little bit. And, if you have a partner that can help you take over that stress while you just need a moment to recollect your thoughts and just need a break for a little bit, that's okay. You know, babies can cry. That's okay. They're not going to hurt themselves or anything by crying, but if you need that moment where it's just getting overwhelming for you as a new parent and you need a little break, know when to ask for help if you have a support person or a friend or a grandparent that "Hey, I need a break. I need to take a break for myself," that's completely okay. It happens to everybody. So, I just tell them to make sure that if they get overwhelmed and they're dealing with a crying baby and they've tried the feeding and the holding and, you know, changing the diaper, and they don't know what to do, either just take that break, give it a little chance to see if the baby will settle down, or if they feel that something's wrong with their baby, then call their doctor to figure out what the next step to help that baby feel better.
Melanie: So, wrap it up for us about newborn care, what you tell parents every single day about taking their baby home, why it's so exciting, and why they should come to Hendricks Regional Health for their care.
Dr. Summers: Well, I'm one of the pediatric hospitalists. We have three other partners. I think we provide very superb care with our nursing staff and our partners without OB physicians. I think we all work as a well-oiled machine and we have different experiences and even in our own lives whether we've built our families through adoption or have our own families naturally, I think we all work very well together in making sure a parent is very comfortable in taking their newborn home. We do education in the hospital. We have a newborn cares video that we go over basically anything you want to know about a newborn whether it's changing their diaper, or umbilical cord care, or safe sleep, or what kind of immunizations they should get before discharge, or why a Vitamin K injection is important for preventing head bleeding in babies. We try to make sure a parent is well-prepared and not only do they hear this from a physician perspective, but our nurses are trained also to give the same education. We provide the newborn cares video that we've made for our hospital, and the purple crying video which about how to soothe a crying baby appropriately without harm. We give a copy to each family to take home and use as reference. And then, we make ourselves available. We tell them if they have any questions about their newborn and they haven't established their pediatrician yet, or haven't seen their pediatrician for the first time, we know they're a newborn and we would be more than happy to answer any questions that they might have, even if it's in the middle of the night, to make sure that they get the greatest start for their family.
Melanie: Thank you so much, Dr. Summers, for being with us. You're listening to Health Talks with HRH, Hendricks Regional Health and for information, you can go to www.hendricks.org. That's www.hendricks.org. This is Melanie Cole. Thanks so much for listening.