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Quick reference medical handouts used by Pediatric offices


The ABC's of Baby Care


Automobile safety seats are imperative for transporting your child in the car. Using one is Florida State law. Until your child weighs at least 20 lbs. the car seat should face backward. Since January 1981 all manufacturers of child car seats have been required to meet stringent standards. Make sure the one you purchase meets these criteria. You cannot protect your child by holding them tightly. Always put your newborn in a car seat! Acne of the newborn is a skin rash that appears as whiteheads, blackheads and pimples on the nose, chin, cheeks and occasionally the forehead. No one knows the exact cause, but it is thought to be from maternal hormone stimulation of the baby’s sweat glands. The rash normally clears on its own in four to six weeks.

Breathing in newborns can sometimes be noisy. This is due to secretions that collect behind the throat and nose after laying down. Newborns also have irregular or "periodic" breathing. They will breathe rapidly for a few breaths, then hesitate for up to six seconds, and then breathe rapidly again. This is normal if there is no change in the baby’s color. Occasionally, infants take rapid, progressively deeper breaths to completely expand their lungs. Burping your baby helps remove swallowed air, but needs to be done only two to three times during a feeding: midway through the feeding, at the end of the feeding, and five minutes after the feeding. If you do not get results in 30-60 seconds, stop trying. Babies do not always need to burp! Bathe the baby daily with warm water and a mild soap (like Johnson’s Baby Soap). Remember not to immerse the baby in water until the cord falls off completely.

Cigarette smoke should be banned from the house once the newborn arrives. Infants exposed to the harmful chemicals in passive smoke experience an increased incidence of crib death (SIDS), colic, pneumonia, colds, asthma, allergy and ear infections. When the newborn comes home, the "No Smoking" signs go up and smoking family and friends go outside (or better yet, quit!) Do not leave your infant with a caretaker who smokes. Crying is an infant’s first language. Since little babies cannot use the telephone or fax to say that they are hungry, fatigued, bored or have a little stomachache, they cry. Some babies cry more than others, but the amount of crying is not related to the infant’s general health or a parent’s skills. Try to soothe the crying newborn, but if nothing works, letting the infant cry will not cause the baby to feel insecure. Remember, crying is normal and a harmless part of the first year of life. Circumcision care consists of covering the penis with a gauze coated with a large amount of Vaseline for three to four days. The circumcision might bleed a little, but call the doctor if it bleeds continuously.

Diapers can be either cloth or disposable. In my experience the rate of diaper rashes is about the same. The main advantage of disposable diapers is that they are convenient; the main disadvantage is that they are more expensive than cloth diapers.

Eye color will not be known for at least six months, but most parents will know eye color by two to three months of age. Occasionally newborns will have a discharge from their eyes. This is usually due to a plugged tear duct- the channel that normally carries tears from the eyes to the nose is blocked. This common condition usually clears spontaneously. During the first few weeks of life, the newborn’s eyes may occasionally cross, and this is normal. By three to four months of age, however, check with the baby’s doctor if the eyes are not straight

Father’s have a very important role in the care of the newborn. The era when only mothers changed diapers and gave their infants baths is over. Be prepared to lose some sleep as night crying and feeding will be tiring, but Dads should help Mom by volunteering for this duty. Dads need to develop a relationship with their newborn; after all, mom has had the baby for nine months, so fathers have some catching up to do! Dads should arrange their work schedule so they can spend extra time at home. The Fontanelle or "soft spot" centered atop the newborn’s head is actually a space where the skull bones have not completely come together. As the brain grows during the first two years, this "open" area will gradually close. Although it appears delicate, do not worry. Protected by a thick elastic membrane, the soft spot is really quite tough. It’s okay to touch and wash it.

Grandparents are great for helping with newborns. They are a valuable source of information, wisdom, experience and reassurance and make great baby sitters. If your newborn baby does not have grandparents, adopt some! Gas- About 10 percent of babies have daily fussy crying that we call colic. The infant appears red faced and frantic, with legs drawn to the abdomen as if in pain with the passage of gas. Colic usually occurs at the same time each day, usually in the early evening from 4-8PM, and may last for hours on end. Colic is not a disease, it will not hurt your child in any way, and it is not caused by being anxious, first time parents. Any kind of motion seems to make colic better: placing your child in a windup swing, taking them for a stroller ride around the house, or for a long ride in the car. Colic is best cured by time- it usually disappears by 3-4 months of age no matter what you do!

Hiccups are common in healthy newborns, sometimes occurring six to eight times a day. Everyone has a theory about what causes hiccups and there are just as many home remedies to stop them. Fortunately, hiccups cause no medical problems and become more infrequent with passing weeks. For treatment, ask a grandparent.

Intestinal problems worry new parents. Some newborns have a bowel movement with each feeding while others have only one every five to six days. It is not uncommon for the infant to strain, grunt and become red-faced when having a normal bowel movement. A child is "constipated" when the stool is pellet like, dry and hard. Occasional blood streaking on the outside of a bowel movement is caused by a small sore or fissure in the rectum and is not a cause for alarm. Immunizations are extremely important; they are safe and help to prevent life-threatening medical problems. Most newborns today get their first immunization against hepatitis B at one month of age. Your baby’s doctor will advise you of the immunization schedule. Parents should remember to add the newborn to their health Insurance plan. The time for registering the infant is sometimes limited and should be done immediately after the child’s birth.

Jaundice is the yellow skin color many newborns get due to increased amounts of a pigment in the body called bilirubin. Often it is caused by immaturity of the liver that leads to a slower processing of bilirubin. Newborn jaundice normally disappears by one to two weeks of age for formula fed babies and one to three months for breast-fed babies. If parents are concerned about your infant’s color, take the baby outside as the degree of jaundice is best judged in natural light.

K is for kitchen. Now is a good time to introduce Dad to the area of the house so Mom can get much needed rest. And for all that Kodak film- do not worry about taking pictures - that flash will not hurt their eyes.

L is for love and kisses. You can not give your newborn too much holding, attention and love. Your baby has its own language, which you soon will soon learn to understand. And do not be afraid to talk the newborn in normal adult language; it stimulates all areas of their brain! Lanugo is the fine hair on the baby’s shoulders and back that is produced near the end of pregnancy and disappears in the first weeks of life.

Mothers at Home (1-800-783-4666) is a nonprofit organization devoted to the support of mothers who choose to be at home with their children. They publish a monthly journal that contains articles, essays and poems reflecting the unique perspective of women caring for their children at home.

Nails on the fingers and toes need to be cut weekly to prevent self-inflicted scratches. These are best trimmed when the child is asleep and the job usually requires two people. Use fingernail clippers or special baby scissors.

Ointments and lotions can be helpful if your newborn has cracked skin or dry skin. Avoid powders with talcum because it can cause chemical pneumonia if inhaled into your newborn’s lungs.

PKU test for a treatable cause of mental retardation (phenylketonuria) was automatically done before your newborn was discharged but will be repeated either at the hospital or your doctor’s office at two weeks of age. Almost all babies have normal screens. Another disease screened at the same time is hypothyroidism. This is a thyroid deficiency that retards brain development, but if treatment is started early enough, babies with this condition can be normal.

Questions are an important part of your well child checkups. Do not be afraid to ask your baby’s doctor about anything that bothers you, even if the question seems "silly." The only "dumb" question is the one you do not ask- you’ll never get the answer to that one! ("It is the frequent not the hesitant inquirer who makes real and safe progress" - Sir Francis Bacon) Q-tips should not be used for cleaning out your infant’s ears. You will only push the wax and other material further down the ear canal and you could injure the ear should your newborn suddenly turn.

Rest is very important for new mothers and fathers. Take the phone off the hook, disconnect the doorbell, and take a nap when the newborn sleeps. Ask for help- no one should be expected to care of a young baby alone. If a mother does not take care of herself, she will not be able to care for her baby. So find the time for sleep, privacy and guilt-free moments to adjust to the new family member. All children get diaper Rashes. They are caused by chemical irritants produced by the combination of bowel movements and urine as well as heat and moisture in the diaper area.

Sneezing is normal and does not mean that your newborn has a cold. This is how your newborn clears mucus, fuzz from blankets, dust in the air, Aunt Jenny’s inexpensive perfume and cigarette smoke from their nose. Infants should always Sleep on their backs unless instructed differently by the newborn’s physician. Newborns are affected by estrogen hormones received from the mom during the pregnancy and as a result parents may notice temporary Swelling of the baby’s breasts. This is common in both boy and girl infants and usually disappears by the time the baby is three months old.

Thrush appears as white patches that coat the inside of your baby’s mouth. It is caused by a yeast germ and is a nuisance but not a serious medical problem. It can be treated with medication prescribed by your doctor and is not contagious. Telephone- call the baby’s doctor if you have any problems. Remember, you may not talk to the physician. The office nurse or assistant are well trained to handle routine phone calls and know that all new parents are concerned.

Umbilical cord care consists of applying rubbing alcohol to the base of the cord where it attaches to the skin once or twice daily. Do not worry, it will not hurt the baby. Try not to cover the cord with a diaper as air exposure helps with separation (which occurs naturally in a week to ten days). Report any redness or foul odor to your child’s physician. A few drops of blood oozing from the stump is normal.

Vomiting and spitting up is common in newborns. It is important for parents to understand the difference between the two. All babies spit up small amounts soon after feeding or sometimes up to an hour after they are fed. Real vomiting means throwing up large amounts of the feeding and if forceful, it is called "projectile vomiting." If a baby vomits two consecutive feedings, parents should call their doctor. Sometimes it is due to overfeeding or failure to sufficiently burp the baby, but it also may mean that the infant has a gastrointestinal problem of some kind. Vaginal mucus and blood are frequently seen in newborn girls. This discharge is due to the natural exposure to mothers' female hormones and will be gone after the first week. New babies are like magnets - they attract everyone. The last thing new parents need is to entertain people who might not understand the needs of a new family. So, restrict Visitors to short visits and make sure guests leave their children at home.

Well checkups for your newborn begin at different times depending on your doctor’s schedule. During these visits your newborn’s physical and developmental growth will be checked. Changes in caring and feeding of your baby will be suggested if necessary. Immunizations against life-threatening diseases will be given at the proper times. These regular checkups will assure you about your baby’s progress and give you the opportunity to ask questions concerning your child’s care.

Xcellent idea is to get someone you trust to care for your newborn and spend a few hours away from home and from the responsibility of parenting.

Yawning, chin trembling, lower lip quivering, and jitteriness of the arms and legs, especially when crying, are all normal newborn behaviors. They are caused by an immature nervous system, and will disappear by two or three months of age.

Zzzzz.. Newborns generally sleep 16 hours a day but not more than two hours in one stretch. The infant generally goes through seven different sleep/awake cycles in a 24 hour period. In the first few weeks, infant gurgles, snorts, sneezes and irregular breathing are bound to keep parents awake wondering what will happen next. Most first time parents like their newborn in the same room with them at night until they feel comfortable that they will hear their baby cry. Trust me, this is one fear that is unfounded! You will hear your infant when the baby needs you!

 

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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