THE FIRST WEEKS

This is the getting-to-know-you time for everyone - infant, mom and dad. Schedules take a while to be established and worked out for everyone. During the first week you'll see the infant's bowel movement change from a sticky, dark-green stool to either the liquid breast-fed stool, or more formed formula-fed infant stool. Jaundice, a yellow coloration of the skin due to liver immaturity, shows up often by day two or three of life and then slowly goes away. Several rashes may show up which may concern you but are unimportant. Daily all of you will "settle in" together more and more.

By two weeks of age the umbilical cord will most likely be separating, and if you had a boy and he was circumcised, the circumcision area will be healed.

By now, you will have experienced sneezes, hiccups, fussy periods, burps, spit-up, some nasal stuffiness, all normal infant behaviors, including the baby sleeping sixteen to eighteen hours a day. Danger signals in the newborn period for which we should be called include an axillary temperature greater than 100 degrees and poor to absent feedings for several feedings.

By two weeks of age, your baby should be back to his/her birth weight.
  

Breast feeding advantages include ready availability, appropriate nutrition and provision of immune benefits. Begin breast feeding as soon as possible. Placing the infant at the breast starts the natural stimulation process. Use both breasts at each feeding, starting with five minutes and add a minute or two each time your infant is with you so that by the time you go home your are nursing your infant ten to twelve minutes at each breast each feeding. Nipple cleansing will be shown to you in the hospital, and milk itself is a good natural nipple lubricant. Be sure that the infant "latches" to the whole areola (the colored portion of the nipple). Stroking the cheek closest to the breast will stimulate him/her to "root," that is, turn his/her head to the breast and open his/her mouth. All this is "doing what comes naturally."

Supplementing with water or formula is not necessary. Adopting a positive attitude is all-important. Adapt to your own experiences; don't be swayed by well-intentional advice of others. As you have questions or perceived problems, check with us. 

Bottle feeding with prepared formula will also provide appropriate nutrition. Cow's milk is not recommended for the first year of life. Babies will take two or three ounces per pound of body weight per day in the first several months. The following table can act as a guide:
  

The label on the formula contains instructions on appropriate preparation of the formula. Formula should be warmed before offering it to the infant. Microwave heating of formula on the high setting is not recommended.

"Burping" your infant should be attempted once or twice during the feeding and at the conclusion of the feeding. All infants swallow air during feeding regardless of how they are fed. In an upright position, whether it is over your shoulder or sitting upright in your lap with the head/neck supported, rub or pat his/her back. Bringing up small amounts of milk may also occur during burping. This should not cause alarm unless it is forceful and frequent.
  

GENERAL CARE

Your newborn infant will probably sleep sixteen to eighteen hours out of twenty-four, being awake only for feedings. The crib mattress should be firm and flat, or with the head end of the mattress elevated one or two inches. This can be accomplished by placing blocks under the legs at the head end of the crib. To decrease the risk of Sudden Infant Death Syndrome (SIDS), we recommend that a baby be placed on his or her back or side to sleep.  Sleep patterns will vary. Night feedings may continue until four or five months of age normally.

A 6-year campaign to reduce the risk of Sudden Infant Death Syndrome (SIDS) has resulted in fewer deaths attributed to the condition, a new report indicates. However, steps need to be taken to encourage more parents and caregivers to place infants on their backs for sleeping, experts say. The American Academy of Pediatrics began the "Back to Sleep" campaign in 1994 after research showed that infants placed on their stomachs increase their risk of SIDS. The rate of SIDS in the United States fell 38 percent during the first two years of the campaign and the number of infants placed on their stomachs to sleep declined significantly. Read more from Mayo Clinic site
  

One particular type of fussiness begins at about two weeks of age and continues for up to two months. It may last for several hours and continue for up to two months. After you have determined that the baby is clean, dry, fed, color is normal, breathing is normal and he/she has had normal bowel movements recently, some things that may help are: feeding, motion such as rocking, riding in a car, or a pacifier. There is no single activity on your part that will work every time. Don't feel you are doing something wrong. Time will take care of this. If you feel that these periods are too frequent, severe, or that your baby is ill, you should notify us.
 

If you see blood in the bowel movement, you should notify us.