Ø      Most babies lose 6 to 10 ounces of weight during the first few days of life.  It is the extra body water that is lost.  They typically regain their birth weight by the second week.  Bottle fed babies regain it more rapidly than breast fed babies.

Ø      The upper lip can develop a sucking blister in the middle.  This is normal.

Ø      The umbilical cord dries and falls off in 1 to 3 weeks.  Keep it clean with Q-tips dipped in alcohol around the base of the cord once or twice a day.  Use the “cut away” newborn diapers or keep the diaper folded down below the cord to allow it to dry.  It may ooze blood intermittently during the healing process.  It may become foul smelling after one or two weeks if not cleaned appropriately.

Ø      White mucous or even blood from the vagina during the first week or two is normal.

Feeding, Stooling, and Voiding:

Ø      Some mothers are afraid that their baby is not getting enough milk while on the breast.  This happens especially in the first several days after birth.  If your baby is feeding 8 to 12 times a day and having 4 to 5 wet diapers with two or more stools per day, is alert and bright eyed, then he or she is getting enough milk.  It is important that the baby be positioned tummy to tummy toward mom and latched on correctly in order to breast feed effectively.  For help, call the Breast-feeding Resource Center at Clovis Community Hospital (559) 324-4940, Lactation Clinic at Saint Agnes (559) 449-5376, or

(559) 449-5120, or the Le Leche League.

Ø      Some babies feed only five minutes and then fall asleep.  It is important that the baby nurses actively at the breast (listen for the baby’s swallowing).  To keep the baby awake, rub the head, tickle the feet, burp frequently, or even undress the baby.  Don’t let your baby go longer than four hours without feeding, even if it means awaking him or her.  It’s also okay if baby wishes to feed as often as every one to two hours.

Ø      Most babies do some spitting up.  The baby is probably keeping down most of the milk, but to reduce spitting up, you may do the following: burp more often during the feeding, give more frequent feedings (but make them a little smaller), hold the baby upright for 30 minutes after a feeding or place him or her in an infant seat for 20 to 30 minutes, or perhaps change the formula type (if bottle fed).  Call us or see us if the baby is vomiting too much, or has projectile type vomiting (shooting it out 2 to 3 feet) and not gaining weight.

Ø      Your baby will go through growth spurts at 2 to 3 weeks, 6 weeks, and 6 months, and may have a sudden increase in feeding demand.  Allow him or her to nurse on demand and avoid supplementing with formula if at all possible.

Ø      From day one, hiccups occur often, usually with each feeding.  They are normal.  Don’t try to stop them.

Ø      By day 2 to 4, the baby may only have 2 to 3 wet diapers a day.  This will increase as the breast milk increases in quantity.  Baby should have six or more wet diapers a day.  Remember, disposable diapers have greater absorbency and you may not be able to tell if they are wet or not – test the weight or feel a diaper by pouring 2 to 3 tablespoons or more into the diaper.

Ø      Frequent loose stools are normal for babies.  The breast-fed baby will have a yellow, seedy, runny stool after each feeding.  Bottle fed babies will have two or more loose-to-soft yellow stools a day.  The stools will be black on the first day of life, then turn green for a couple of days, and finally yellow.  As the baby gets older, he or she may have only one stool every 1 to 5 days.  If they are eating and feeling well, this is okay.

Ø      Constipation can occur later.  This means hard (sometimes “pebbly”) stools, which are difficult to pass.  You may try 1 to 2 tsps. of sugar in a bottle with 2 to 3 ounces of breast milk or water.  Try it once or twice a day as needed.  After two weeks of age, one ounce of diluted prune juice can be given once or twice a day.  You may occasionally use a pediatric glycerin suppository.  Some babies may have a large soft stool with a lot of crying and straining.  Try the above measures and see if it helps.

Ø      A pink or orange spot on the diaper comes from normal urine crystals.

Ø      All babies get diaper rash.  It comes from the stools and urine irritating their skin.  Occasionally, a yeast infection may be the cause of a fiery red diaper rash with raised lesions or little bumps.  Most diaper rashes can be treated by cleansing the skin with water, avoiding diaper wipes, and applying a layer of Desitin, A&D Ointment, Balmex, Triple Past (which can be purchased in our pharmacy), or Vaseline to protect the skin from the next soiling or voiding.  A yeast infection can be treated with an over the counter anti-fungal cream such as Lotrimin, or Miconazole.  If the baby has white patches in the mouth along with the diaper rash, a prescription oral medication will be needed.

Miscellaneous Concerns:

Ø      Babies may be sleepy the first few days of life and may be difficult to awaken for feedings.  For the first week, awaken the baby to feed if four hours have passed.  Some babies sleep during the day, but are awake at night.  That’s okay.  Try waking him or her up every 2 to 3 hours during the day to feed.

Ø      The “startle” reflex is normal.  The baby will shoot out its hands and arms in response to a noise or strange touch.  Swaddling the baby makes him or her feel more secure.  The chin quivers and the fingers tremble momentarily.

Ø      All babies sneeze occsionally or often.  They may also sound stuffy during the first few weeks.  It doesn’t mean they have a cold (in the first week of life).

Ø      Funny noises, squeaks, and grunts can be heard from a normal baby.  They also breathe irregularly.  They can pause in their breathing up to 5 to 10 seconds occasionally.  You can be assured baby is fine if the color remains normal and pink.

Ø      All babies cry!  All babies have different temperaments. Some cry readily and some are very calm.  Some babies are “easy”, but some take a lot of time to calm down once the crying has begun.  Read Dr. Berry T. Brazelton’s book, Infants and Mothers, for a nice description of temperaments in babies.  Calming the unpredictable, demanding, “difficult” baby can be stressful, time consuming, and extremely challenging for a new parent.  Dr. Brazelton’s most recent book, Touchpoints, discusses crying and development stages in greater detail.

Ø      Guests and visitors are appropriate if they help you, but inappropriate if they are distracting you and taking up your time when you need to be resting and breast-feeding your infant.  Let your visitors know what you need from them, and they will usually be willing and glad to help.  Let others do the cooking, cleaning, and laundry.  At least for the first week, discourage a lot of visitors.  Put pertinent birth information on the answering machine and let it do the rest!  Mom needs her rest and plenty of time to get acquainted with her baby and to learn how to breast-feed.

Ø      Yes, babies are different.  Relax, and get used to it.

What is Upsetting or Disagreeable to Baby?

Ø      Loud noises which trigger the startle reflex and crying.

Ø      Baby may be hungry.

Ø      Wet or soiled diaper that needs changing.

Ø      Awake and no one to socialize with.  Please realize your baby may like the social holding and your talking very much and often.  Go ahead and do it, you cannot do it too much!

Ø      Too cold or too warm.

Ø      Pain from gas, cramps, tape on skin, or burning diaper rash.

Ø      Stuffy or congested nose, making it hard to breathe.

Ø      Visiting the church nursery or other public places where other children and adults pass on that first cold virus with a friendly kiss or hand caress.  Give your baby a month before encountering these virus carriers.  Blame this restriction on your pediatrician.  We don’t mind – we want your baby well!

When can I take my baby out?

Ø      It’s California!  Do it.  The weather is fine, especially in the afternoon.  Just dress baby appropriately.  There is nothing wrong with the outside air, except on high pollution days.

Ø      If the temperature is comfortable for you, it’s okay for your baby, indoors and out.

Ø      Avoid crowds of people, and ask that people not touch your baby the first month (you don’t know what they have had their hands on!).  Explain that your pediatrician ordered it.  Then they won’t be insulted.  But use your judgment.

 Why Babies Cry:

 Ø      Gas, soiled diaper, hot, cold, too quiet, too much noise, stomach cramps, or can’t pass BM.  Some babies are simply not getting enough “socialization.”  Hold him or her, sing or talk to her.  Babies cannot be “spoiled.”  There is no such thing.  However, some need “neurological discharge” time, which means they’ve had input all day long – being held, cuddled, and stimulated a lot, and now they need a bit of time to cry and unload.  It’s OK.  Let your baby have a good cry.  Most babies go through this.  Give us a call if you believe your baby is ill.

 Solutions to Crying:

 Ø      Take care of the above items.

 Ø      An active baby who feeds eagerly, has no fever, and is alert when awake, is almost always a WELL baby.  So, relax!  You probably don’t need to call the doctor.

 Ø      Reduce household noise if the baby startles easily or has a difficult temperament.

 Ø      Purchase a cotton “sling” or infant carrier to hold and support baby close to you.

 Ø      Sing or talk softly, play soft gentle music, use a ticking clock in the crib, or rock the baby.

 Ø      Massage the baby gently.

 Ø      Heating pad or warm water bottle to warm sheets in crib.

 Ø      Burp frequently, baby may have too much gas.  Check hole in the nipple, it may be too big causing baby to drink too fast, gulping too much air with the formula.

 Ø      Did baby fall?  Did brother or sister pinch or hit baby?  Check for injuries.

 Ø      A good pair of tennis shoes is sometimes the only thing that works – lots of holding and walking.  If your baby responds to this, do it.  If you’re too tired, ask spouse, grandma, or others to take over.

 Ø      If on Similac or Enfamil, try switching to Isomil, Prosobee, and Lactofree.  Some babies are intolerant of both cow milk and soy formula, and therefore respond well to Nutramigen or Alimentum.  They are twice the cost, but it may be worth a try.

 Ø      You have fed, changed, bathed, soothed the baby, and now you are tense.  The baby is still crying.  He/she is tired.  Rocking may perhaps only continue the stimulation.  So, lay the baby down in the crib and let him or her unload with a good cry.  In 15 to 20 minutes, the crying may perhaps melt into sleep.  We call this “neurological discharge” time.  Read about it in Touchpoints by Berry T. Brazelton, MD.

 Ø      If nothing is working, visit us at the office.

 When to Call or See the Doctor:

Ø      Fever over 100-101 degrees, especially if baby is acting ill or feeding poorly.
Ø      Excessive vomiting or diarrhea.
Ø      Relentless crying in baby who feeds poorly or not very active
Ø      Labored breathing
Ø      Progressive coughing
Ø      Turning blue
Ø      Sores in the mouth
Ø      Lethargy
Ø      Poor feeding
Ø      Jaundice (yellowness) of the whites of the eyes, or yellow skin progressing from head and chest to the arms and legs.