Catawba Pediatrics would like to congratulate
you on the birth of your child!


We are truly glad that you have chosen to bring your newborn to Catawba Pediatric Associates.  We offer a wide range of services including well child care (newborn through college age), sick visits, emergency clinics on and weekends, and phone advice by registered nurses 24 hrs a day. 

Please see the section under "office information" for complete details regarding our hours of operation and office policies.

 
 

It is very important that we see you and your newborn in our office 2 days after you go home from the hospital.  This is the time when jaundice can become worse or other problems arise.  Please call our office to make an appointment for this visit.  When you come, enter through the adolescent side of the building to help minimize exposure to sick children.   

Since we are just learning about you and your newborn, we would appreciate your completing the accompanying forms concerning your pregnancy, birth history, and your newborn's health.  If you do not remember the answer to a certain question, please make a reasonable estimate or leave blank.  Someone will go over the completed form with you.  Please add at your next visit any information which you may have at home or elsewhere.  This form, like the entire medical record, will remain confidential and not be released to anyone without your approval. 

New patient history form

It is important that you bring the completed forms with you for the initial visit.

Newborn Care

Below is some routine newborn information that may assist you in caring for your newborn.  Many common questions are answered below.  If you do not find the answer to your question please call us or discuss it with us at your next visit.

 
 

Newborn Care - Download as a PDF

Introduction

Doctor Visits

Baby Visits

Newborn Features

Nutrition

Types of Formula

Vitamins & Iron

Solids

Newborn Characteristics / Behavior

Newborn Care

Well Baby Visits

Circumcision

 
 

INSTRUCTIONS IN THE CARE OF THE NEWBORN INFANT 

INTRODUCTION

These instructions are written as an aid to you in caring for your newborn during the first several weeks.  They are general guides only.  Use them where they are helpful; disregard them where they do not apply to your baby or your situation.  Your baby is a distinct individual.  He will do some things by the "rules" but will do others for which no rules have been written.  You must, then, avoid being overly rigid; he cannot be raised strictly "by the book". 

Listen carefully but cautiously to the advice of well-meaning family and friends.  While a helpful but not overbearing family member or close friend is of great assistance during the first few days at home, remember that your child is different from theirs and their experiences will not be totally applicable to your situation.  In addition, there is a large body of "folk" advice available which is often more colorful than factual.  So collect suggestions from a variety of sources, but judge the advice with your own special knowledge of your baby.

IN THE HOSPITAL

DOCTOR VISITS

After your baby is born, the hospital nursery will notify our office.  If the infant appears normal to your obstetrician and to the nurses in the newborn nursery, we will first see your baby on our regular hospital rounds within 24 hours.  Should the baby experience any difficulty during labor or is a sick newborn, he or she will be followed by a Neonatologist (sick newborn specialist) until his/her problem has resolved.  Your infant will be seen by the doctor each morning, and you will be advised of his daily  progress.  Nursery visits will be made on a rotational basis by members of our group; you will probably meet one or two members of our practice during your hospital stay.  We hope that you will ask us to discuss with you any questions which you may have concerning your baby.

BABY VISITS

After your baby is delivered, your newborn will usually be placed under special warming lamps to help your baby regain body heat lost during delivery.  After several hours of warming, he will be bathed.  The baby can remain in your room throughout the hospital stay or may go back to the nursery for periods of time.  Techniques for infant feeding are discussed in another section of these instructions.  Help with specific problems can be obtained from the nurse who helps care for your baby.  These nurses are experts in feeding techniques, each having the experience of feeding many babies before.  Use them and ask their assistance in helping you develop a suitable feeding technique for your baby.  Do not be overly concerned with minor feeding problems during the first several days.  New babies often show little interest in feeding initially; some have frequent spitting while others are difficult to "bubble" or "burp".  We will follow your infant closely and investigate fully if his behavior is truly abnormal. 

NEW BORN FEATURES

Certain normal features of newborns often cause concern to parents during the hospital stay.  Seldom are they of importance to the infant's health and should cause no worry.

These features include: 

  Misshapen Head (Molding) - The skull of the newborn is not firm as in older children and adults. It is often abnormally shaped immediately after birth due to the pressures exerted on it during passage through the birth canal.  It will assume a more normal shape within 24 to 48 hours.
  Curved Legs and Feet - Part of the baby's adaptation to the uterus is having legs and feet that curve and bend to help them fit inside.  Most often lower legs and feet fold and curve inward to some degree.  These should straighten with time.  We check the feet by noting whether they will assume a normal position with gentle pressure.
  Rashes - Newborns have a variety of skin variations.  Should your child have an abnormal rash, we will notify you.
  Birth Marks - Most areas of redness or pigmentation present at birth will disappear within several months.  Red splotches are almost always present on the upper eyelids and the back of the neck.  These are prominent collections of small blood vessels and will gradually fade.
  Jaundice - The amount of yellow pigment (bilirubin) in the blood rises in all infants soon after birth due to the inability of the baby's liver to change the pigment to a substance that can be eliminated by the body.  In some babies, the concentration of this pigment reaches a level at which a slightly yellowish-orange color (jaundice) may be noticed in the skin.  It causes no problems in the baby unless it rises to an extremely high level.  Once a baby becomes jaundiced, we will take the necessary measures to prevent it from rising extremely high.  Usually this pigmentation is a normal condition and should cause no concern.  If there are more serious reasons for the jaundice, we will notify you promptly; otherwise, you need not worry.

Above all, enjoy your baby during the hospital stay.  You will have plenty of assistance in caring for him.  Use this time to get acquainted.  Attempt to learn correct techniques of infant care but avoid being rigid or overly concerned.  It is most important to the total well-being of the child that your initial contact with him be a pleasant, relaxed experience.

NUTRITION

GENERAL

Nutrition is an important aspect of the care given to your new baby.  The most common cause of poor growth is improper nutrition.  Proper feeding should begin during the newborn period.

Nutrition requirements are supplied during the first few months either by breast feeding or by bottle feeding.  This decision is one you will have to make based on your own preferences.  Either will be satisfactory as long as you are comfortable with it.  Almost every mother will have sufficient breast milk for her baby; almost every baby will thrive on formula or breast.  Whether you breast feed or formula feed make sure you use clean supplies for each feeding.  Clean your bottles, nipples, and other equipment with hot soapy water or in a dishwasher on hot cycle.  Be certain to rinse well before using.

FEEDING SCHEDULE

Whether breast feeding or bottle feeding, we recommend a demand feeding schedule.  Allow the infant to sleep as long as he wishes.  When he awakens, allow him to take whatever amount he will take willingly.  Most infants will establish a pattern of feeding every three to four hours.  In general, a demand feeding schedule allows the infant to guide you in supplying his actually food needs.

BREAST FEEDING

The American Academy of Pediatrics (AAP) and Catawba Pediatric Associates (CPA) encourage mothers to breast feed.  Here are some facts that the AAP would like you to know.  "Human milk and infant formula are different. Not only does human milk provide all the protein, sugar, fat and vitamins your baby needs to be healthy, but it has special benefits that formulas cannot match. It helps protect your baby against certain diseases and infections. Because of the protective substances in human milk, breastfed children are less likely to have the following: ear infections (otitis media), allergies, vomiting, diarrhea, meningitis, pneumonia, wheezing, and bronchiolitis.  Research also suggests that breastfeeding may help to protect against Sudden Infant Death Syndrome (SIDS)." (www.aap.org)

  Technique - Cleanliness is of utmost importance.  The breast should be washed with soap and water daily. One of the secrets to breast feeding is relaxation.  You should sit and rest several minutes before beginning nursing.  Seated comfortably and holding your baby with his head supported, place a finger on each side of the nipple and press slightly so that the nipple protrudes.  Do not push the baby toward the breast.  Instead, gently stroke the cheek nearest the breast.  He will then turn his head and search (root) for the nipple.  If the breast is excessively full or swollen, he may not be able to establish a good  hold, and you may have to manually express some of the milk during the first feedings.  We recommend nursing on each breast each feeding.  Your baby will get most of the milk during the first five minutes of each nursing.  During the first few days of breast feeding, you may wish to nurse 8-10 minutes per breast, extending this time as you and your infant become adjusted to breast feeding.
  Supplementary Bottles - After the first few days of adjustment are over, you may substitute a nursing with a bottle of formula.  This will make it easier for you to get sleep, leave the baby occasionally, or give the father a chance to feed the baby.
  Mother's Diet - Your diet while nursing should be a well-balanced one just as you followed during pregnancy.  There are no essential foods.  Extra milk is usually recommended as it is an excellent source of protein and calcium.  You should try to avoid any food that seems to cause stomach upset or loose stools.  There are many drugs secreted in breast milk.  Always check with us or your obstetrician before taking any medication.  Smoking is never helpful and is not recommended.

TYPES OF FORMULA

Satisfactory feeding technique can be achieved with either glass, plastic, or the disposable "Playtex" type bottle.  Formulas we recommend may be purchased in three preparations:

  Powdered Formula is convenient and the most economical.
 

HOW TO PREPARE:  Into a clean bottle place the desired number of scoops of powder and add two ounces of warm water from the tap for each scoopful.  Place a clean nipple on the bottle and shake vigorously for 30 to 45 seconds.        

EXAMPLE:  2 scoops, add 4 ounces of water;  4 scoops, add 8 ounces of water

  Concentrated Liquid formula is available in 13 ounce cans.  It is prepared by adding equal amounts of water.
 

HOW TO PREPARE:  Wash top of formula can with soap and water, open, and store in refrigerator with opening covered by aluminum foil.  At feeding time, pour equal amounts of concentrated formula and warm water from the tap into a clean bottle and shake briefly.  Return opened can to the refrigerator where it may be kept for 24 hours.  After 24 hours it must be discarded.             

 EXAMPLE:  2 ounces of concentrated formula, add 2 ounces of water to make a total of 4 ounces.

 

Ready-to-Feed comes in small disposable bottles and in quart cans.  It is very convenient but more expensive.

 

STORAGE:  No preparation or sterilization is necessary.  Wash can top with soap and water, open,  cover with aluminum foil, and store in refrigerator for up to 24 hours.  At feeding time, formula is simply poured from the can into a clean bottle.  Allow milk to return to room temperature before offering to your baby.  After 24 hours discard the can of formula.

WATER SOURCES FOR MIXING POWDERED AND CONCENTRATED FORMULA

  City Water should be sterilized until your infant is 3 months old (new AAP recommendation).  You can sterilize your water by boiling it for 5 minutes.  Allow to cool before mixing with formula. Remember to test the temperature before you feed your baby.  After 3 months of age no sterilization is needed.
  Bottled Water should be treated the same as City Water, even if the bottle specifically states "for infant use".  The only exception is bottled water labeled "sterile".  There are numerous brands and types of bottled water.  Read the label carefully.  After 3 months of age no sterilization is needed.
 

Well or Spring Water should be sterilized using the method discussed under City Water or by using "sterile" bottled water until you stop giving formula, usually at 1yr of age.  At 6 months of age your provider will discuss adding fluoride supplements to your child's diet to help build strong teeth.  Your well water will be tested before starting fluoride. Testing kits can be purchased for a small fee at CPA or the health department.

*helpful hint - boil a large amount of water and store in a tight container in your refrigerator until                                    needed.  Do not keep for more than 2 days.

VITAMINS AND IRON

All of the prepared formulas have vitamins and iron added.  No additional supplements are needed.  If you are breast feeding your infant, extra vitamins will be prescribed. 

SOLIDS

An infant that is nursing well does not need food supplements such as solids to meet his caloric needs before the age of 6 months.  There has been, however, a trend in the United States to feed babies at a much earlier age than necessary.  Pediatric nutritionists are now emphasizing that this practice is not only unnecessary but is not desirable.  We therefore strongly recommend that infants not be started on solid foods before six months of age.  We will give instructions at the 6 month well child visit for introduction of solid foods.

NEWBORN CHARACTERISTICS AND BEHAVIOR

CONGESTION

The nose and air passages of infants normally contain small amounts of mucus.  During the first several months of life almost all breathing takes place through the nose. Mucus is normally removed from these passages by sneezing and coughing.  Within limits these are normal, protective mechanisms which help the baby breath easier

BOWEL MOVEMENTS

Normal stool frequency in the newborn varies from as many as 8-10 stools per day to as few as one every several days.  Initially they are often quite loose and usually occur during feedings or soon after.  Many babies will strain, hold their breath, cry, and become flushed in the face while having bowel movements; this is completely normal and does not mean that they are constipated as long as the stool is soft and pasty.  If, however, the stool is very hard, you may add 1 teaspoon of dark Karo Syrup to a maximum of 3 bottles of formula or breast milk in 24 hours.  This will usually soften the stools adequately.  Under no circumstances should laxatives be given to small infants.  Should stools contain blood please notify us.

SLEEPING

Except for brief periods surrounding mealtimes, most infants sleep uninterrupted between feedings.  With a regular home routine, a sleep pattern is usually established within several days.  According to AAP guidelines, the infant should ideally have his own bed and sleep in the parent's bedroom to help facilitate feedings.  Infants should not sleep with their parents.  There is an increased risk of Sudden Infant Death Syndrome (SIDS) when you sleep with your child.  Do not disturb the child's sleep routine by awakening him for viewing by visitors; this may lead to easy and frequent awakening at other times.  Avoid beginning the practices of rocking or walking your child to sleep and the use of night lights.  You should lay your baby down when he is awake and always have him lying on his back.  This will help your child learn to put himself to sleep and decrease the risk of SIDS.  We feel that sleep disturbances and nighttime problems in later infancy and early childhood are usually the result of inappropriate practices begun early by the family.  It is not necessary to maintain excessive quietness while the baby sleeps.  Normal household noises will not disturb him.

CRYING

Infants usually cry several hours per day.  Often they establish a regular period of excessive irritability and crying, usually in the late afternoon or early evening.  These periods are normal and not cause for alarm.  If the infant's feeding and general care needs have been met, crying episodes do not require extra feeding or other special care.

HICCOUGHS

This is very common in newborns, is of no importance, and requires no treatment.

HORMONAL EFFECTS

Hormones received from the mother before delivery may cause transient effects in the baby.  Breast enlargement may be present for several days, often with the secretion of a small amount of fluid from the nipples.  In female infants a mucoid vaginal discharge is briefly present and may contain small streaks of blood.  These changes are normal and disappear within several days.

NEWBORN CARE

You will be asked to bring your infant to our office for a weight and color check during the first few days of life.  This is necessary to assure that the baby is not developing jaundice or loosing too much weight, and for us to answer any questions you may have. 

UMBILICAL CORD

The navel cord dries and usually falls off between five days and four weeks of age.  The navel area should be kept clean with cotton swabs moistened with water.  It is no longer recommended to use alcohol around the cord.  It should be left open to air, and no band or binder should be worn.  Do not let the diaper rub or cover the umbilical area.  After the cord falls off, the stump may continue to ooze or bleed; continue to clean the area until it completely dries.  Any excessive or prolonged drainage should be reported.

BATH

A sponge bath should be given until the navel area is well healed and dry.  After it heals a tub bath may be given.  Sponge or wash the baby with a mild soap.  Baby soaps are available and are fine to use.  However, do not use products that have lavender, rosemary, eucalyptus, menthol or other natural ingredients until your baby is at least 3 months of age.  These products can cause rashes.  Please read the labels on all products carefully.  Most products will specifically state if you need to wait until 3 months of age.  For baths, the water should be lukewarm and the room warm.  Begin with the face and wash the genitals last.  The outer part of the ears may be cleaned with a cotton swab.  Do not attempt to clean wax from the ears as this packs the wax in the ear canal.  Babies naturally have dry skin.  It is not necessary to give your infant a bath everyday.  This will cause his skin to become drier.  A bath 2 to 3 times a week is fine.  When bathing, wash the scalp each time with baby shampoo.  It should be washed from front to back and the soft spot should be scrubbed as well.  Good scalp care will prevent cradle cap.  No oils, lotion, or vaseline should be used on the hair.  After bathing, the baby should be patted dry with a soft towel.  Oils, creams, and lotions are not recommended for the skin as they cut off the circulation of air and may cause rashes.

CIRCUMCISION

The AAP has this to say about circumcisions.  “Scientific studies show some medical benefits of circumcision.  However, these benefits are not sufficient for the American Academy of Pediatrics (AAP) to recommend that all infant boys be circumcised.  Parents may want their sons circumcised for religious, social and cultural reasons.  Since circumcision is not essential to a child’s health, parents should choose what is best for their child by looking at the benefits and risks.”

Medicaid no longer covers the cost of circumcisions.  If you wish to have your newborn boy circumcised and you have Medicaid, you will need to prepay.  Payment must be received before the procedure is done.  We accept cash, money orders, and most credit cards.  We cannot accept checks for payment of circumcisions. 

Most insurance companies pay for circumcisions.  Check with your insurance company to verify your coverage. 

CPA will perform circumcisions either while the newborn is still in the hospital or at CPA’s Hickory office until the newborn is 2 weeks old.  After that age your child will have to be referred to a urologist for this procedure.

If a circumcision is performed, no special care is needed other than keeping the area clean with soap and water.  The end of the penis will be red and tender for several days, and a small amount of blood may ooze.  If excessive bleeding occurs, please notify us.

For further information about circumcisions go to the following links:

General Information

Common questions 

DIAPER AREA

The baby's diaper should be changed as soon as possible after soiling.  The area should then be washed with a soft cloth, soap and water.  Should a rash appear, more frequent changes are indicated.  It may be helpful to keep the baby out of the diaper for 2 to 3 days.  Any of the ointments available for diaper rash may be used after each change.

CLOTHING

Your baby does not require any more clothing than an adult.  Dress you baby according to the temperature.  Many parents keep their babies too warm which may cause an elevated temperature. 

VISITORS

Avoid excessive handling of your baby by visitors and prevent exposure to large groups during the first several months.  While there is no increased risk of infection during the newborn period, even minor problems such as cold are miserable illnesses in the very young infant.

OUTDOORS

After the two week check-up, you may take your baby out whenever the weather is pleasant.  Remember not to dress him excessively or expose him to large groups for a while.

ROOM TEMPERATURE

Homes should be maintained at an average of 68-70 degrees.  Provide good ventilation during the warmer months.  Air conditioning is not harmful.

WELL-BABY VISITS

The goal of good pediatric care is the avoidance of health problems.  Your infant will be seen on a regular schedule of well-baby visits.  These visits will enable us to identify and correct any problems early.  Our primary emphasis will be on how your child is growing and developing new skills at each age level.  Early in life both growth and the development of new skills change rapidly.  In order to recognize problems early, children are seen more frequently at first and at gradually longer intervals as they grow older.  At each well-baby check, growth measurements will be taken and compared with norms for the child's age.  Similarly, a brief developmental examination will be performed to measure learning progress. 

 

 

 
 
Main Navigation