July 8, 2020

Newborn Welcome Note


Congratulations! Welcome to the practice, or welcome back if you’ve been here before. The purpose of this email is to give you some basic information about your new baby that you can refer to over the coming weeks. 


One of the big decisions you make once you have the baby is what to feed them. Breast milk or formula or a mix of the two? How do we know what the right thing to do is? Who do I call if I need some help? 


First and foremost, what you feed your baby is up to you. We encourage breastfeeding because it is convenient, inexpensive and has some proven benefits to both the mother and the newborn. However, if formula is a better fit for you and your baby (whether you are on medication, you have had breast surgery, or for other personal reasons) it is okay, we are not here to judge you – we are here to help you feed your baby however you’d like. Many families decide to do a little of both. Any of these options work. 


Unfortunately, breastfeeding is not always as straightforward as we imagine it should be. You will get a lot of advice from all kinds of people – nurses in the hospital, doctors, relatives, neighbors, and likely the guy on the corner who is suddenly a lactation consultant. This can be overwhelming. Try and take it all with a grain of salt and do what feels right. “But nothing feels right!” you may say, “my nipples are bleeding and my baby is crying.” Then do not despair – the following information will be encouraging and helpful.


For a first time mother it can take five days (and sometimes more) for your milk to “come in.” With subsequent children it usually happens a little faster. The first 24 hours of breastfeeding can be “hit or miss” and if it doesn’t seem like it is going as planned DO NOT GET DISCOURAGED. This is normal as the newborn is often very sleepy the first 24 hours and won’t be interested in feeding. And that’s okay – unless there is an issue with jaundice or sugar levels, which we will figure out.


Often, during the second night, a lot of parents experience a “fussy” or more demanding baby, one who keeps waking up and is hungry. This is also normal. You are probably making a small amount of colostrum, and they may want more than you are providing. But the key thing to know here is, as they suck more and more and harder and harder, your body will start to make more milk. If you are getting uncomfortable, limit it to every 2-3 hours, with 15-20 minutes on each breast. But if you aren’t uncomfortable, it is okay to let them feed a little longer if they want. Sometimes they may “cluster feed,” meaning they feed for three hours straight and then sleep for three hours straight. This is also okay (as long as your body can tolerate it). 


You won’t make milk unless your baby (or a pump) is telling your body it needs milk every three hours or so. Once you are making a good amount of milk and the baby is gaining weight, you can be a little more relaxed about how frequent the feeds are. 


All of the providers in the practice are comfortable discussing feeding with you, so if you are having difficulties or have any questions at all, please call or make an appointment. Furthermore, we have lactation consultants who we will be glad to refer you to if necessary. 


Infection and Vaccines 

Infants receive a lot of vaccines during their first year of life. As pediatricians, this is one of the most valuable things we do. They serve to protect your baby from many serious and fatal diseases. At each visit we will go into more detail about the scheduled shots. 


In the hospital they will offer the baby his/her first Hepatitis B vaccine. Many parents ask why they should give this vaccine to a newborn. Are they at risk? The answer is that Hepatitis B can be passed from the mother to the infant during birth, so this is an extra measure to make sure your infant does not contract it. If you choose not to give the Hepatitis B vaccine in the hospital, we can give the first dose in the office. 


Infants under eight weeks have to go to the hospital if they have a temperature of 100.4 or above. We encourage you to take the temperature of your newborn rectally. If you do not know how to use a rectal thermometer feel free to bring it to the first visit and we will show you how. More importantly, this is why we discourage anyone sick from being around the infant, and encourage all visitors to wash their hands before handling the baby. If your newborn has a temperature of 100.4 or above, please call us — morning, noon or night. 


There are two vaccines we recommend that anyone who comes into close contact with the infant receive: the flu vaccine and pertussis vaccine. Pertussis, or “whooping cough”, causes a nagging cough in adults, but if passed onto an infant can be very serious. 


Normal Baby Sounds and Weird Things They Do 


Please note that it is normal for a baby to 

  • breathe really fast intermittently and sound snorty some times 
  • have peeling skin after the first few days 
  • sneeze and hiccough a lot 
  • cross their eyes 
  • occasionally make a high pitched wheezy sound during a feed or when sleeping 


Again, feel free to call with questions. It can take some time for you to get used to what a newborn is like, so if something doesn’t feel right give us a call and we will help. 


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