Preparing for a new baby is a time full of excitement and anticipation … and maybe a twinge of terror. Two pediatricians — Kate Chaplinski, M.D., of Brandywine Pediatrics in Wilmington, Del., and Natasha Burgert, M.D., of Pediatric Associates in Kansas City, Mo., offer their advice and answer 20 common — and pressing — new parent questions.
1. Should I follow the recommended vaccination schedule?
Chaplinski: “Absolutely, regardless of what you read online and hear from laypeople. The Centers for Disease Control and Prevention (CDC) has done decades of research with thousands of people that say that the reason they’re scheduled as they are, the ones that are given when they’re given and in combination with others, those are the ones that have proven to be most effective at preventing diseases. Some families may go by their own schedules, but I do say that those schedules are not backed by science and may leave their children inadequately protected.”
2. What are newborn screens?
Burgert: “The newborn screen is drawn before parents and baby go home from the hospital. The tests vary from state to state. Usually it involves a heel prick on the baby’s heel to get blood. They do a varying amount of tests specifically looking for genetic disorders that would cause significant damage to the child if they’re not caught early. These are things that by 2 weeks of life, your kid would be very sick very quickly.”
3. Should I wait to take my newborn out in public?
Chaplinski: “The out-of-doors is not a problem. Large family events are the most unsafe. A lot of times, people are sick before they even know it. It’s particularly dangerous for babies under the age of 2 months to get sick and then have a fever, which invariably means a trip to the hospital and a hospital evaluation requiring some invasive tests. Out into the world and into the open, absolutely, but if you’re going somewhere where people would be hugging and kissing and holding the baby, I’d be very cautious of that under the age of 2 months. Going to a place like Target should be fine. If a stranger comes up, you can politely say, ‘Please don’t touch my baby.’”
4. Is it normal for my baby to cry so much?
Chaplinski: “Infants cry a lot. They can spend up to three to five hours a day crying (not in a row). Always do your best for your baby, but in the end, if you’ve swaddled and changed and rocked and fed and everything that you can for your baby, ultimately, babies sometimes just cry to relieve some energy. You’re not a bad parent if you put them in the bassinet or crib for a few minutes while you go collect yourself and then come back to your baby after you feel a bit more re-energized.”
5. I plan to breastfeed. What should I expect?
Burgert: “Make sure you’re eating and drinking. It affects the quality of the milk and your levels of fatigue. You need a partner to bring food to you because breastfeeding can take six to eight hours a day. We like to see breastfeeding moms consume at least an extra 500 calories a day. I think moms have a tendency to think, The baby is born, so now I can start working on getting my baby weight off. It’s a significant concern for a lot of moms, and they do it prematurely and make things more difficult sometimes.”
Chaplinski: “Everyone assumes it will go absolutely swimmingly with no problems at all. It’s a rare parent and rare family that don’t struggle with breastfeeding in some capacity. Yes, everyone should do it and, yes, it’s the right way to go, but it’s so rare that there’s not an obstacle or a struggle with it. You can’t beat yourself up. Try your best, but in the end, if you do encounter struggles, seek help. Ultimately, it may not be for everybody.”
6. Where should I go if I do need help with breastfeeding?
Burgert: “Usually the hospital where you delivered will have lactation consultants, so you should be able to see someone in the hospital. The La Leche League website is wonderful, and also KellyMom.com. Most communities have hospitals that have free breastfeeding support groups.”
7. How often should I feed my newborn?
Burgert: “Newborns need to be feeding at least every 2 to 3 hours for the first few weeks of life, regardless of if they’re breastfed or formula-fed. It’s not until they get back to their birth weight, which is around 2 weeks of life, that they will start to space out their feedings. It’s still pretty frequent, and most of the time you have to wake them up to do so to make sure they’re getting enough to eat.”
8. How do I know if my baby is getting enough to eat?
Burgert: “They should be having an appropriate number of wet and dirty diapers, based on what you were directed in the hospital. It’s roughly one wet diaper per day of life up to a week. Other than that, the baby can feed on demand.”
9. Are there substances I should avoid consuming while breastfeeding?
Chaplinski: “People should be very cautious about their alcohol intake — preferably none, if possible. Caffeine is okay in small quantities. If you want to have one to two cups of coffee a day, that’s absolutely acceptable. Don’t eat more than more than 4 to 6 ounces of high mercury-containing fish. As far as medications go, you’re not supposed to take Benadryl or Advil. Tylenol is fine.”
10. Is there such a thing as nipple confusion?
Chaplinski: “Probably. We discourage the use of pacifiers or nipples in the first 2 to 3 weeks of life. After that time, once the baby has regained his birth weight — usually by about 2 weeks of life — and the breastfeeding cycle is well-established, another family member can bottle-feed the baby. After 2 to 3 weeks is also a good time to introduce a pacifier.”
11. If I decide to bottle feed, what should I know?
Chaplinski: “It’s easier to overfeed a bottle-fed baby than a breastfed baby. Breastfed babies are usually more in charge of their own nutrition. When they’re finished, they turn away from the breast. You can’t make a baby latch, but a parent can keep reintroducing the bottle to the baby. Be even more sensitive to the baby’s cues.”
12. Where should my newborn sleep?
Burgert: “Newborns should sleep on a flat surface with no additional blankets or pillows. It should be a firm mattress. There should be no bumpers. That can be either in a crib or a bassinet.”
13. What else can I do to prevent SIDS?
Burgert: “Breastfeed and vaccinate.”
14. How often should I bathe my baby?
Chaplinski: “Newborns don’t need to be bathed more than two to three times a week, at the most, especially in the wintertime when the air is particularly dry and cold.”
15. What causes diaper rash, and how should I treat it?
Chaplinski: “The most common diaper rash is just an irritant diaper rash from moisture being held against the skin. The best way to prevent that is frequent diaper changes. Sometimes if the baby is on antibiotics, that can change the bowel flora and germs in the poop and irritate the baby’s bottom. In rare instances, babies are allergic to some of the materials in diapers. If it’s run-of-the-mill irritant diaper rash, I like ointments containing zinc oxide. Desitin is a good one, with 40 percent zinc oxide, which is a higher concentration. If you’re consistently using that high concentration of zinc-oxide ointment with every diaper change for two to three days in a row and it’s not getting any better, or it’s getting worse, the baby should see a doctor.”
16. How should I care for the umbilical cord?
Chaplinski: “Clean the area around the cord with soap and water or a very mild cleanser, just like you would the rest of the baby. You don’t want to submerge the area in water until the cord has fallen off, usually at about 2 weeks of age.”
17. What are signs that my baby needs to see the pediatrician right away?
Burgert: “Extreme fatigue, like they’re not going to the breast because they’re so tired, or when they start eating, they won’t finish because they fall asleep. Certainly fever, of 100.4 degrees or higher when taken rectally. Rashes are something that I want to see. It doesn’t matter what part of the body it’s on. Also, if the baby is not peeing or pooping.”
18. Should I use special baby detergent for my baby’s laundry?
Chaplinski: “It depends on whether there’s a family history of very sensitive skin. Some babies have very uniquely sensitive skin from the beginning. In that case, I would use Dreft or some of the hypoallergenic detergents, or if there’s a family history of eczema or very sensitive skin. Otherwise, some babies do fine using the detergent the rest of the family uses.”
19. What are some signs of postpartum depression?
Chaplinski: “Everyone is going to feel a little sad at some point and question whether they’re being the best parent they can in the first couple months. You’re going to worry about things you never realized you could worry about before. But if you’re consistently feeling guilty for whatever reason, you’re not enjoying your baby or getting pleasure in any of the things you used to get pleasure in, you can’t stop crying, you feel this overwhelming sense of either helplessness or hopelessness, or extreme sadness that lasts more than a month, that would be unusual.”
20. How can I deal with the stress and exhaustion of being a new parent?
Burgert: “Be realistic. Understand there are going to be limits to what you can do … you can’t do everything. It’s great if you can partner with a spouse or significant other to divide and conquer some of the duties so that especially a breastfeeding mom can get four consecutive hours of sleep. She’ll feel like a million dollars.”
Chaplinski: “Rest, rest, rest. There are always thank-you notes to write, things to clean and things to be done around the house, but if you don’t lie down at least once or twice a day for a nap to regain your energy, you’re going to make yourself and everyone else unhappy. Take care of yourself. All those other things you’ll get to eventually.”