We’re going home with our newborn today. What do we need to know?
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SIGNS OF ILLNESS
The most important things to know prior to bringing your newborn home are signs of illness. The following symptoms should be reported IMMEDIATELY.
- In the first 2 months of life, a fever is a temperature of 100.5 degrees F or higher. Take the temp in the armpit or rectally and do not add any number to the one that you read; report the temperature as it appears on the thermometer. If your infant has a fever, please call us immediately.
- Forceful vomiting over and over (not just spitting up), especially if associated with blood or bile (green-yellow colored fluid).
- Frequent, loose, watery stools, especially containing blood or mucus.
- Any respiratory problem – color changes to blue or gray, breathing rapidly, working hard to breathe.
- Too fussy or irritable – if you can’t get your baby to settle down no matter what you do.
- Too sleepy – if you can’t get your baby to wake up no matter what you do.
If any of the above occur in your newborn, especially fever under 2 months of age, it often means that we have to do some bad things to them to make sure they do not have a serious infection. This usually includes blood cultures, urine cultures and spinal fluid cultures. Hospitalization for 2 days with IV antibiotics is often included. We do not do this often, and when we do, it is usually not serious, but it can potentially be devastating, so we must treat all babies under 2 months of age with a great deal of caution.
The best way to avoid illness and all of these bad things are to avoid sick people and avoid busy places at busy times. If people are sick, they should not visit your newborn. Keep your newborn sheltered as best as you can for the first 2 months of life. Good hand washing is important for everyone.
SLEEP
Your baby should sleep on his BACK ONLY, not his side, not his stomach, and not in bed with you. This is the safest way to prevent SIDS – Sudden Infant Death Syndrome, or crib death. We do not recommend side sleepers or positioners. Remember “Back to Sleep.”
We will give you an excellent sleep handout at your 2-week visit, but here are two tips to help establish good sleeping patterns long term that you can start once you arrive home.
- For scheduled naps or nighttime sleeping, lay your baby down to sleep when she is drowsy but not yet asleep. This will help her learn that her crib or bassinette is where she is supposed to be when she goes to sleep. Do not rock or feed your baby to sleep, or she will come to expect it.
- Do not let your baby sleep longer than 3-4 hours in a row during the daytime to prevent her from getting her days and nights mixed up. If she has a long period of sleep you would much rather it be at night.
CAR SEAT
Bring your car seat to your room in the hospital so you can get the straps adjusted properly for your new baby. Shoulder straps should be tight enough to allow only two adult fingers to fit between the baby’s chest and the straps. Check your vehicle's owner’s manual to find the proper location for your child’s car seat. If allowed, the car seat should be placed in the center of the back seat. If you are not able to place the car seat in the middle, either side is acceptable. All car seats should be rear facing for the first year of life. Many newer cars also have tether straps for added safety.
BATHING/CORD CARE
Sponge bathe your baby until the umbilical cord is off and the area is completely dry. Take care of the cord as directed by the nursery staff (often alcohol pads 1-2 times per day). The cord usually falls off around 2 weeks of age.
CIRCUMCISION
A healing circumcision is like a really bad rug burn. It turns oozy and greenish-gray as it heals. Put plenty of Vaseline over the head of the penis to prevent it from sticking to the diaper. The area should be healed in about one week.
FIRST OFFICE VISIT
Call our office (585-7827) during regular office hours to schedule your baby’s first visit. First-time breastfeeding mothers and their newborns will usually be seen 48 hours after discharge from the hospital. We usually see all newborns by 1 week of age. Bottle-fed babies or second-time parents may be seen at 2 weeks of age. Your doctor will tell you when your child needs to be seen prior to discharge from the hospital. Please use our exit door (the far left door) to enter the office while your child is under 2 months of age to limit their exposure to illness and other children. Get someone’s attention when you enter and we will show you where to sign in and direct you from there either to an exam room, or to our couch room, which is for well infants under 6 months of age. A sick newborn, or one with siblings present may need to go to the regular reception area.
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