Any relationship worth having takes time, patience and understanding. Baby care is no exception. There may be a noticeable difference among the personality of your baby and other babies you have had or have known. Some easy babies just seem to slip into an already established family routine, while other perfectly normal babies appear more difficult or assertive from the very beginning. Either way, trying to satisfy them and needing to be a perfect parent, can be quite a challenge. These early problems will resolve as you gradually learn to interpret your baby's expression of needs or desires, such as I'm hungry, I'm tired or I'm awake. Each need develops its own special sound that you may soon be able to recognize.
At each stage of infancy and childhood, your child will present you with new parenting challenges, questions and hopefully sources of great pleasure. Remember, the staff of Palm Beach Pediatrics is there to help you through each phase of your child's development.
Always remember to trust your judgment and your knowledge, and by all means, keep your sense of humor!
This section is intended to provide an introduction to the routine care of your newborn infant and to answer some commonly asked questions.
Keep visitors to a minimum for the first few weeks. Both the baby and mother need time to rest and adjust. In addition, especially at this time, you should want to avoid contact with people who have colds and other contagious diseases. Newborns are more susceptible to infections.
The first stool passed by a newborn baby is called meconium. It is a thick, sticky blackish green material. After a few days, the stool changes to a more green and loose consistency which is called a transitional stool. When a baby is breast-fed, the stools tend to remain loose and sometimes almost watery but become yellow in color, contain seed-like particles, and resemble grainy mustard. Stools of a bottle-fed baby are yellow-brown and seedy, and are often loose and gassy. These formula stools are usually firmer than breast-milk stools.
The frequency of the stools varies from as many as one during or after each feeding to one every three or four days. Some very normal breast-fed babies will have bowel movements only every 7-10 days! When they go, it's usually an explosion for several diaper loads!
Many babies will bear down or strain when they feel gas or stool. They may turn red in the face and appear somewhat fretful. This is normal.
Abnormal stools are those which are excessively watery, rock-hard, or contain blood or mucus. A drop of blood may be normal and may come from a small anal fissure. Call us for abnormal stools.
If your newborn son has been circumcised, petroleum jelly (Vaseline and others) may be applied to the penis on the day of circumcision to keep the diaper and urine away from the freshly circumcised penis. During the healing process, you will normally see a thin layer of whitish semi-liquid material, which some parents often mistakenly think is a sign of infection. This is the appearance of normally healing tissues and should not cause alarm. Within a few days the only care needed is washing with water and mild soap. Do not use alcohol.
If the Plastibell system was used, the plastic ring should fall off in 6-7 days. You probably received a brochure that describes the healing process. If you have any questions about this, please contact your obstetrician first and then us if you do not receive a satisfactory explanation.
The enlargement of the scrotum is normal and is related to hormonal changes. It is often normal not to be able to feel one or both testicles. If you ever notice any sudden swelling in the groin area or discoloration of the testicles, notify us. This may be a surgical emergency.
Excessive crying in the early months without any apparent cause may be due to colic. The typical colicky infant behaves as if he has a tummy-ache, with doubling up or screaming. It probably comes from your baby's over-reaction to what he is feeling in his stomach, such as gas, hunger, or acid reflux. Some of the things that may help include:
- A change in position to more upright
- Increased burping
- Movement or vibration
- Formula change, if bottle-fed (check with us first)
- Avoidance of certain foods by the mother, if breast fed
- If breast fed, have mother increase her fluid intake
- Abdominal massage
Colic can be one of the most frustrating problems for parents. In fact, it is usually worse on mothers and fathers than it is on the baby. It makes you feel helpless when you just can't make your little one comfortable. By two to three months it almost always goes away. Call us for advice on this problem if you are unsuccessful in your treatment.
Keep the umbilical cord clean and dry by using rubbing alcohol at least four times a day. The top of the remaining stump is already dry so it is not necessary to concentrate on this part. However, the base of the cord closest to the skin needs to be cleaned and manipulated in order to help it fall off. Even though you may think that it hurts when you are doing this, it does not. It will hasten the healing by drying and removing the dark, crusty material. The cord usually falls off by 2-3 weeks of age and the navel will heal. After the cord is removed, there may be a small amount of fluid drainage or spotty bleeding for several days. Just keep cleaning this occasionally to remove the old blood. You can bathe the baby at this point and you can leave the navel to dry without covering it or applying any ointments. If you notice pus or redness at the base of the cord, contact our office for instructions.
Babies cry for many reasons. Unfortunately, since infants can't tell you why they cry, parents have to guess, and often misinterpret their baby's crying for pain or serious problems. Many times babies are tired or hungry, and soon you will be able to differentiate between these states. You will also soon be able to tell if your baby is really in pain. Typically, pain is accompanied by a high-pitched cry.
Many parents ask how long is it safe to allow a baby to cry. The best and most reassuring answer is that it never hurts a baby to cry for a little while. This usually bothers the parent more than the baby. If your threshold for crying is very short, you won't feel comfortable allowing your baby to cry for even five minutes. It is all right to let the baby cry for 15-20 minutes, during which time the baby will usually fall back asleep either on their own. Be sure to reassure your baby and checked that there is no obvious problem.
During waking hours, diapers should be changed frequently. After each bowel movement, wash gently with water, rinse and dry. Air-dry the diaper area several times a day for at least a few minutes. Conscientious daily skin care will be rewarded by a minimum of skin problems and a more comfortable baby. A diaper ointment may be applied to protect the area from the irritation of urine and stool. However, pre- moistened diaper wipes and soap may be irritating to some babies, and should not be used when your baby has a rash. If the rash appears pimply or pustular, call us for advice. However, understand that since rashes are difficult to describe over the phone, it may sometimes be necessary for us to see your baby in the office.
When cleaning the baby's vagina, wipe gently from front to back. This is to reduce the possibility of urinary tract infection. Some infants will have a vaginal discharge with or without a slight amount of blood. This is normal within the first week of life and is related to the maternal hormones. Do not scrub excessively in an attempt to remove all of the white cheesy secretions which are present and which protect the sensitive skin within the folds of the vagina. The labia normally remain slightly swollen for at least 2-3 weeks. This swelling is also related to hormonal changes.
Jaundice is a medical term for the yellow discoloration of the baby's skin and eyes due to accumulation in the blood of a chemical called bilirubin. Unlike adults or an older child, the presence of jaundice in a newborn usually does not indicate a problem, but rather that his or her liver metabolism is not fully mature. Jaundice appears in about 70% of healthy full-term newborns, and in a larger percentage of premature infants. In many cases, however, time is the best medicine, and treatment including phototherapy (lights) is usually not necessary.
Jaundice usually reaches its peak on the third or fourth day. In breast-fed babies, it will often persist until 4 weeks. In these cases, we will be following the decrease in bilirubin over this period. With rare exceptions, breast-feeding does not need to be discontinued.
Normal babies may sleep 18 to 20 hours daily during the first few months. They will awaken when they are hungry or uncomfortable. After four to eight weeks, the baby will usually begin to sleep longer at night and may omit a night feeding. This will provide you with some well-needed rest
When newborn babies wake up more frequently during the night than during the day, they probably have their days and nights mixed up. This usually corrects itself; but sometimes this pattern becomes well established into the first several months. If you want to try to change the pattern, try waking the baby more frequently during the day even if they don't seem to want to wake up or feed. Then allow them to stay asleep as long as possible during the night. This attempt at changing an upside-down sleep pattern can sometimes take a week or so, but it usually is worth it since it gets the baby onto your normal day-night schedule.
Sneezing is usually not a sign of illness; it is simply the baby's way of clearing his nostrils of dust, lint or other irritants. Sneezing accompanied by a cough or difficulty breathing is not normal and you should call us.