Nutrition

Feedings

• Amounts - Babies need approximately 50 calories per pound of body weight each day. Both breast milk and formula contain 20 calories per ounce and all the nutrients required. Therefore, your baby should consume approximately two to two and one half ounces per pound of body weight in each 24-hour period. There is no need to supplement with other food or excess water. Call our office if your child seems to lack interest in breast or bottle feeding, or if your baby's appetite suddenly decreases.
• Preparation - Prepare commercial formula by the manufacturer's directions. Boiling water is only necessary until baby is one month of age if using well water. It is not necessary to sterilize bottles; washing in hot, soapy water or the dishwasher is adequate.
• Frequency - As a general rule, babies should be fed on demand. Full-term infants require feeding approximately every two to four hours, both day and night. Some breastfed babies may want to nurse slightly more frequently. Please see the breast feeding links for more information. Breastfed newborns may be supplemented with a bottle of pumped breast milk or formula one time a day beginning at two to three weeks of life, if desired.

Vitamins

The AAP recommends supplementing exclusively breast fed babies with vitamin D. One such supplement, Poly-vi-sol, can be purchased over the counter; give one dropper full daily. Nursing mothers should continue their prenatal vitamins.

 

Development

At this age your baby should:

• Readily locate the nipple for feeding
• Have a strong sucking reflex
• Respond to light, noise and movement
• Tightly grasp with his hands

Vaccinations

There are no vaccinations given to your child at today's visit.

Common Issues and Concerns

Medications

At this age you should not give your infant any type of medication without advice from your physician

Sleep

• The AAP recommends that all newborns be placed on their back to sleep. Use a firm mattress. No pillows or heavy quilts should be in the crib
• Hold and cuddle your baby if crying…gentle motion seems to induce comfort and sleep. You can't spoil them at this age.
• Don't let your baby sleep more than three consecutive hours during the daytime.
• Do not feed your baby if he cries and less than two hours have passed since the previous feeding. Babies who feed frequently during the day become hungry at frequent intervals during the night.
• Make middle-of-the-night feedings brief and boring. Don't turn on the lights, talk to, or rock your baby. Feed him quickly and quietly.
• Call our office if your child doesn't seem to be as active, wants to sleep more or is hard to wake up.

Fever

At this age a fever may be a warning sign of a serious infection. A temperature over 100.5 degrees taken rectally is considered a fever in a newborn. Contact your physician IMMEDIATELY if this occurs. Do not give Tylenol or any other medication before your child is evaluated by a physician.

Jaundice

While jaundice is common in the newborn, it is usually gone by two weeks of life. In some breastfed babies, it is normal for jaundice to last longer. Contact your physician at 4 weeks of life if your child is still jaundiced.

Head Shape

While it is important that all children sleep on their backs, giving your child belly time while awake and supervised will help prevent him from favoring one side of his head and allows him to develop other muscle groups. Changing the side of the head your child sleeps on will also help prevent a flat head shape called a positional skull deformity.

Gastroesophageal Reflux

Spitting up is a common occurrence in the newborn period. Let your doctor know if your child's spit up seems excessive, associated with fussiness or causes choking episodes.

Eye Drainage

Blocked tear ducts (lacrimal duct obstruction) are a common occurrence and may cause a thin watery or mucousy eye discharge. Conjunctivitis which is a bacterial infection can look similar but usually the white part of the eye is red and the drainage is much thicker than with a blocked tear duct. Call our office if you are concerned.

Car Seat

Your child needs to be in a DOT approved car seat that is rear facing until one year of life AND their weight is greater than 20 pounds. Use the car seat in the back seat of the car and make sure the seat is securely belted into the car.

Crying

Crying is normal for newborn babies and may occur for many different reasons. Most babies will develop a fussy period toward the end of the day between 3 and 12 weeks of age called colic. This is the baby's way of winding down after her day. Make sure she is not dirty or hungry. Try picking up the baby, cuddling, walking or rocking in a slow, soothing manner. If your child cries more often, or seems more fussy and cannot be calmed in the usual way, please call our office. Remember, it is not usually something you are doing wrong, so DON'T BLAME YOURSELF.

Breech Presentation at Delivery

Because of the risk of developing dysplasia of the hip, it is recommended by the American Academy of Pediatrics (AAP) to have the hips of newborns born breech screened at 4-6 weeks of life by hip ultrasound or by an x-ray at 4-6 months of life. Let your doctor know if your child was born breech.

Normal Behavior Patterns

• Stooling - Bowel movements are highly variable in frequency, amount, color and consistency. Each baby is different.
• Breathing- It is normal for your child to have periods where he breathes fast and shallow and then slowly. This is called periodic breathing. It is also normal to have high pitched inspiratory (when he takes a breath in) squeals from time to time. Contact our office if your baby displays any of the following: rapid breathing all the time, inspiratory squeal associated with pulling in of the chest, or has a pale, bluish or marbled color or appearance. 
• Rashes- Babies have sensitive skin and frequently develop transient rashes.
• Hiccups, Sneezing and Passing Gas are all normal occurrences in the newborn period.

Recommendations

• Do not put your baby to bed with a bottle or prop it in his mouth; propping leads to swallowing more air, spitting up and even choking; it can also cause ear infections
• Your baby will thrive on formula or breast milk. Do not give your baby juice or solid food at this time.
• Your hot water heater should be set for less than 120 degrees to prevent scalding or burns from hot water.
• Make sure your house or apartment has a smoke detector on each level.
• Keep hot liquids and cigarettes away from baby; they could burn the baby.
• All smokers should smoke outside of your house or apartment.

Next Well Child Visit

Your child's next well child visit should be when he/she is two months of age.