New Baby Care

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 Before Baby Comes

Words of advice: Make time to meet your baby!

Please plan to spend at least 2 weeks with your baby, your partner, and as few other people as possible. Organize friends and family to help around the house, so you can focus on your baby, yourself, and your new job as a parent. The world outside the womb is a system shock for your baby. You can learn so much about your baby as you watch them respond to this new experience.

 

Newborn Care At The Hospital

There is so much to know about a new baby! If you are feeling overwhelmed, consider the education at Nurtured Nest. These classes are created by medical providers, educators, and child development specialists.

 Newborn Care At Bloom

  • This first visit will be a Well Visit! It takes most new families at least 20 minutes to leave the house for your baby’s first check up. You are encouraged to bring a written list of questions or concerns. We will check your baby’s weight and height (or length since they’ll be lying down), and both will likely be smaller than the hospital! The weight loss is normal and real; the shorter length happens because we measure to the heels and the hospital nurses measure to the toes. Many babies are more jaundice after they go home, so we may need to check a bilirubin level in the office. We will also reserve time for a lactation evaluation in addition to baby’s check up, so bring any supplies you may want, like a nursing pillow or nipple shield.

  • Your baby will need a check up every 1-2 days until they are gaining weight and jaundice is improving. These visits can include lactation consultations if needed, or parents can enlist a private lactation consultant who comes to their home. These will be billed as Simple Sick Visit or Complicated Sick Visit depending on the concerns we are addressing and how much time we spend going over your baby’s care.

  • Your baby will have a well check at 2 weeks. Most babies will be back to their birth weight, and many will weigh much more, but don’t automatically assume something’s wrong if your baby isn’t fully back to birth weight. Most babies have lost their umbilical stump by this visit, but some babies still have their cord attached.

 Safety Tips for Newborns

  • A safe sleep surface will be firm, flat, and separate. Every inclined surface, from a car seat to a Mamaroo will state it is not intended as a sleep surface. Even some play pens will state this disclaimer. The surface should be firm and flat because a surface that is too soft or at an incline (or both) might allow a baby to scoot or shift so that the neck sits at a funny angle, usually with the chin down on the chest. Babies as old as 4 months have suffocated from falling asleep in a seat or on a surface that allowed this neck angle to happen. A baby can roll onto their side by themselves, but should never be propped to sleep on their side by a caregiver. Babies should also sleep on their own separate surface. Even twins and other multiples should have their own space, because tiny babies are already capable of scooting around a crib or bassinet. Also, when babies spend more than 30 minutes a day in an inclined seat, they are at a significantly higher risk of plagiocephaly, or flat head. If plagiocephaly gets severe, your baby will need a helmet, which is expensive and time consuming because you’ll have to see a specialist every week for 2-4 months!

  • Young babies under 4 months aren’t strong enough to get their face out of a blanket or your side. But these babies are able to roll and scoot. That means babies should be on their own surface, with no blankets, pillows or toys. Bumpers can no longer be sold in the US and should not be used in a crib. Babies should have their own sleep surface so we don’t accidentally get blankets, pillows, or ourselves on top of them. There are behavioral studies that discuss benefits of safe co-sleeping, and these have very specific guidelines regarding the family’s sleeping arrangement. However, these have not been endorsed by the American Academy of Pediatrics because studies of separate sleeping areas show significantly less SIDS risk. Although babies need their own sleep surface, they should be in a room with an adult, or the adult should be connected to the baby with a monitor. This allows parents to be in tune with their baby in a way that significantly reduces SIDS risk. (FYI, being in tune doesn’t mean you keep them from crying, so please don’t hear that you have to fix the crying everyday!)

  • A safe car seat will be one of the most important things you acquire for your baby, but it doesn’t have to be the most expensive. If you are gifted a car seat from a friend or family member, be absolutely sure it is safe. If a car seat was in the vehicle during an accident which caused the airbag to deploy, the seat is no longer safe (even if no child was in the seat at the time). There are two types of seats: infant and convertible. Infant seats have a handle and can be carried. They aren’t necessary, but they can be very convenient. Convertible seats can convert from rear-facing to forward-facing. Be careful - some seats convert from forward-facing to booster seats. A booster seat is not expensive and should not be used until a child is 6-8 years old. Seats are often described by their weight capacity: look for a seat with a max weight of 40lbs rear and 65lbs forward (or better).

    A car seat should be checked by an expert. You can find an expert using our Resources page. Rear-facing seats were pioneered by astronauts. Your child’s seat should be rear-facing until a child has the neck development of a preschooler. Infants and toddlers have small necks with soft shoulders and jaws, and very heavy heads (at least compared to their bodies). When a child’s jaw and collarbone are more defined, they usually have the bone and muscle development to support their head in an impact.

  • Babies are at a higher risk of complications from infections than adults. For the first 2 months, you should minimize the number of people who meet your baby. In general, you should trust that anyone who comes into your home would tell you if they had any illness symptoms, and is willing to wear a mask if there are any possible symptoms or if they have been exposed to someone with a cold. During this time, unless there is a ridiculous pollen count outside, you should assume anyone with a runny nose or cough has an infection, not allergies; this includes parents! Older babies, kids, and adults can contain infections to specific parts of the body, but new babies can’t. A head cold can turn into an infection of your baby’s whole body, or even their brain. Also, babies don’t show an infection like older babies and kids. Instead of getting hot, some babies get cold, or their temperature just swings between hot and cold more dramatically. If a baby actually gets a temperature over 100.4 or below 97.7, you should call the office immediately. A rectal thermometer is the only type you should trust. Sometimes babies just “forget to breathe”; when they are sick. This is called apnea and you’ll see your baby wait 10-15 seconds to take a breath. Little pauses in breathing can be normal and happen a lot in the first 2 months. But if you see apnea lasting longer than 15 seconds, or happening more than usual while your baby is sick, call the office immediately. It’s also important that all adults who interact with babies have received certain vaccinations. All caregivers should receive the TDaP booster because it contains the Pertussis (Whooping Cough) vaccine. Most people get a tetanus booster every 10 years, but this is only the TD. to get the whooping cough part (aP), you have to make a special request. You can get it at your own doctor or at any pharmacy. Adults should also get their flu and covid vaccines, even if you don’t normally choose these vaccines. These vaccines rarely stop a person from getting sick, but babies are much less likely to get the flu or covid from a vaccinated adult than an unvaccinated adult, so you are protecting a baby when you get this vaccine. Also, vaccines do protect against severe illness and complications. Babies need their parents, so it’s important to keep parents as healthy as possible!