Most Common New Parent Questions Answered: Teleclass Re-cap

We were so lucky to have some of the country’s top pediatricians on hand from Weill Cornell Medical Associates for this important and highly informative teleclass. In case you missed it, you can listen to the taped teleclass here.

Below are just a few of topics that were covered during the class, both generously sponsored and expertly presented by Weill Cornell Medical Associates. *All articles below are from the Weill Cornell Medical Associates Health Library.

Eating

How often your baby needs to eat will depend on your baby’s age and how hungry he or she is at that moment. As your newborn grows, you can try these tips:

• At about 3 weeks, you can try delaying feeding for a short time by cuddling or talking with your newborn. Your newborn’s nervous system is mature enough that he or she can wait longer between feedings and interact with you more at this age. Take cues from your baby. Don’t force your baby to engage with you when he or she is not responding and appears to be very hungry.
• You might be able to limit nighttime feedings if you avoid socializing with your baby and lingering after he or she has finished eating. As your baby wakes up for the next feeding, try to respond before he or she starts to cry a lot. During the feeding, keep the light off and use a soft voice. Your baby will feed and go back to sleep easier if he or she is calm. If you find that you want to give your baby more attention during nighttime feedings, plan for a time you can rest the following day to avoid fatigue. By age 2 months, many babies begin eating less frequently at night.

At age 3 to 4 months, babies become more and more interested in the world around them. Babies often interrupt feedings by looking around, smiling, cooing, and reaching for a parent’s face. This is a normal attempt to turn feeding times into a more social event and an opportune time for parents to interact with their babies.

At age 4 to 6 months, most babies can start to eat solid foods. This complements breast milk or formula. Try to be patient as your baby experiments and learns new eating skills like chewing and using cups and utensils.

For more information about feeding, see the topics Breast-Feeding, Bottle-Feeding, and Weaning. Follow your doctor’s advice on when and what to feed your baby.

Diaper changes

You may be surprised at the number of diapers your newborn goes through every day. It’s important to change your baby’s diaper, because urine and stool can irritate your baby’s skin. It’s also good to monitor your baby’s diaper habits so that you can get a sense of your baby’s health.

Many newborns who are breast-fed have 5 to 10 bowel movements a day. They may have as few as 1 or 2. Formula-fed babies tend to have 1 or 2 fewer bowel movements a day than breast-fed babies.

After they are a few weeks old, babies may go 2 days or longer between bowel movements. This usually is not a problem as long as the baby seems comfortable and is healthy and growing and as long as the stools are not hard. Your newborn’s bowel movements usually will change from black to green in the first few days. Then they will change to yellow or yellowish brown by the end of the first week. Breast-fed babies typically have more yellowish bowel movements than formula-fed babies. For more information about stool color and when to call the doctor, see Bowel Movements in Babies.

The number of diapers a newborn wets is sometimes hard to know, because disposable diapers work so well to wick moisture. In general, though, your newborn should have at least 3 wet diapers a day for the first few days. After that, your baby should have at least 6 to 8 wet diapers a day. The urine should be yellow in color. Don’t be alarmed, though, if you notice a pink color to the urine during your newborn’s first 3 days of life. It is common for newborns to pass crystals in the urine (highly concentrated urine) which makes the urine look pink. If the pink color lasts, or if at any time your baby seems to be in pain while urinating, call your doctor.

Call your doctor if your baby does not regularly produce wet or dirty diapers and shows other signs of dehydration, such as strong-smelling urine that is a dark yellow color.

Sleeping

A newborn moves between sleeping and waking during a 24-hour day. Most newborns sleep for a total of 18 hours each day, waking for short periods at least every 2 to 3 hours. When your newborn wakes up, he or she will usually be hungry and need to be fed. This pattern dominates your baby’s first few weeks.

Sleeping patterns vary with each child and gradually evolve over the first year. Sleep habits are influenced by the baby’s temperament and feeling of being well fed and the parents’ response to waking episodes. Some babies naturally seem to need more sleep than others.

Periods of murmuring and restlessness every 50 to 60 minutes are a normal part of the baby sleep cycle. These periods are known as “active sleep.” The restlessness usually lasts a few minutes, and if babies are left alone, they usually fall back to sleep.

The sleep cycles include:

• Drowsy sleep. The baby moves little but may be wakened easily. His or her eyes may start to close or gently open. Drowsy sleep can occur at the start or end of the sleep cycle.
• Quiet, or deep, sleep. The baby moves very little; has deep, regular breathing; and has no noticeable eye movement under the eyelids. The baby is not wakened easily.
• Active, or light, sleep. The baby appears restless and breathes quickly and irregularly. Eye movement is noticeable under the eyelids. A 1-month-old may spend about 50% of his or her sleep time in active sleep, while older children and adults spend about 20%. It is believed that a baby has longer periods of active sleep than an adult because the brain is developing rapidly.

At first, babies often sleep through loud noises. But at about 3 to 4 months of age many babies become easily disturbed by noises like the phone ringing or a dog barking.

During a baby’s first few months, maturing of the brain allows the baby gradually to sleep for longer periods. By age 3 months, most babies sleep for their longest period (up to 7 to 8 hours) during the night and develop set nap times. They are also more alert when awake and you can gradually add time between feedings. At about 3 to 4 months, start bedtime rituals to help your baby relax. Read a story, play quiet music, sing, rock your baby, or give him or her a gentle massage. Avoid loud music or sounds and bright lights.

Sleep patterns often change during the second half of the first year. By 9 months of age and into the second year of life, it can be hard for some babies to let go of the excitement of the day. Also at this age, many babies want to exert control over their actions. Because of these things, your baby may resist going to sleep at the times you want. To promote a regular schedule, stay with your routines when your baby resists going down for a nap or going to bed at the usual time.

Requirements for car seats

Buy a car seat appropriate for your child’s current age, weight, and height. For safety, it is very important to have a car seat that fits your child and faces the right direction. Be sure to follow the car seat maker’s recommendations. They should include weight and height guidelines. They should also tell you how to install the seat and how to secure your child in it.

The following guidelines come from the National Highway Traffic Safety Administration (NHTSA):

Ages 0 to 12 months

Your child younger than age 1 should always ride in a car seat that faces the back of the car (called rear-facing). There are different types of rear-facing car seats. Infant-only seats can only be used rear-facing. Convertible and 3-in-1 car seats typically have higher height and weight limits for the rear-facing position, allowing you to keep your child rear-facing for a longer period of time.

Certified Child Passenger Safety Technicians can help you install your car seat and position your child safely. To find help in your area, go to www.nhtsa.dot.gov/cps/cpsfitting/index.cfm or www.seatcheck.org. You can also call the National Highway Traffic Safety Administration at 1-888-327-4236.

What are immunizations?

Immunizations save lives. They are the best way to help protect you or your child from certain infectious diseases. They also help reduce the spread of disease to others and prevent epidemics. Most are given as shots. They are sometimes called vaccines, or vaccinations.

In many cases when you get a vaccine, you get a tiny amount of a weakened or dead form of the organism that causes the disease. This amount is not enough to give you the actual disease. But it is enough to cause your immune system to make antibodies that can recognize and attack the organism if you are ever exposed to it.

Sometimes a vaccine does not completely prevent the disease, but it will make the disease much less serious if you do get it.

Some immunizations are needed only one time. Others require several doses over time to help your body be able to fight the disease (build immunity).

What are some reasons to get immunized?

• Immunizations protect you or your child from dangerous diseases.
• They help reduce the spread of disease to others.
• They are often needed for entrance into school or day care. And they may be needed for employment or for travel to another country.
• Getting immunized costs less than getting treated for the diseases that the shots protect you from.
• The risk of getting a disease is much greater than the risk of having a serious reaction to the vaccine.
• When immunization rates drop below a certain level, preventable diseases show up again. Often, these diseases are hard to treat. For example, measles outbreaks still occur in the U.S.