Pediatrics

Well Visits appointments for the first 12 months are as follows: 48 hour Newborn Visits, 2 weeks, 4 weeks, 2 months, 4 month, 6 months, 9 months, and 12 months

Saline drops for the nose, Bulb Syringe, Rectal Thermometer (very important, and yes it must be rectal), One bottle of Pedialyte or other electrolyte solution, Infant Gas Drops, Emergency Phone Numbers (doctor’s office, poison control)

The American Academy of Pediatrics recommends breastfeeding as the best nutrition source for infants. It also helps the baby to build the immune system and to bond with the mother. But, we know that breastfeeding can be challenging! Your baby should feed every 2-3 hours at the beginning. At each feeding, the baby should spend about 10-15 minutes on each breast. Try to alternate breasts and get as much of your nipple and areola in the baby’s mouth as possible. Feed for no more than 20 minutes on each side to help prevent sore, cracked nipples. If you are sore, putting some breast milk or lanolin directly onto your nipples are some good soothing techniques. In general, you should go no less than 1 1/2 hours or more than 4 hours between feedings. If your baby is slow to wake up, try undressing and stimulating the baby to get ready to feed. The more that the baby feeds, the more milk you will produce. If your baby is having 6-7 wet diapers per day and several yellow or green stools, s/he is getting what s/he needs! If your baby does not seem satisfied, talk to your doctor about supplementation. We try to avoid bottles and pacifiers for at least two weeks to reduce nipple confusion but sometimes the addition of formula can help a low milk supply or just give mom a break for a few hours. Most importantly, the breastfeeding mother needs to watch out for her health and nutrition. Continue to take your prenatal vitamins and drink plenty of water. You can do this!! If you are using formula, we suggest an iron-containing cow’s milk preparation. Although there are many different brands, you should choose one and stick with it, but most babies tolerate them all equally well. Formula-fed babies will initially take anywhere from 1-3 ounces every 3-4 hours. If your baby seems to be having a problem with gassiness, spitting up, diarrhea or constipation, please discuss changes with your doctor before you switch formulas. Babies should stay on breast milk or formula until one year of age. They do not need water or juice at less than 6 months old (even in the warm weather) if they are getting regular feedings. Please delay solid foods (that is, cereal, fruits, vegetables, meats) until at least 4-6 months old! You should also avoid heating the bottle in the microwave or feeding a bottle in bed or while the baby is laying flat.

The leftover umbilical cord will usually fall off when the baby is 2-4 weeks old. You can apply rubbing alcohol on a cotton swab at the very base of the cord (the sticky area closest to the belly) to help it to dry. We suggest that you give only sponge baths until the cord is off and the area looks clean and dry. If you notice a bad smell, discharge or pus, and/or redness, please notify the doctor immediately. The baby’s skin may look dry and flaky, especially on the hands and feet. This is normal and will clear up on it’s own within a week or two. You can use a mild lotion or cream but it may not help much. Many babies also have rashes on the face in the first few weeks of life. These range from small white spots on the nose to full blown neonatal acne. Babies are not bothered by the rashes and there is often little to do until they clear up on their own. Some babies, however, may have eczema or other skin problems that require special care. If you are concerned, call your doctor or ask at the next visit. Diaper rashes are also common. Try to avoid diaper wipes in the first 2-4 weeks and use just a warm cloth. You can apply Vaseline or A&D Ointment after each diaper changing. Other diaper creams, such as Desitin, Balmex or Triple Paste can offer a thicker barrier of protection to babies with frequent redness. If you notice that the area is bright red into the creases with small spots surrounding the area, this may be a yeast (fungal) infection that requires anti-fungal cream. Please see your doctor for any rash that isn’t getting better.

Babies should be placed on their backs to sleep. Since the “Back to Sleep” campaign began, the incidence of Sudden Infant Death Syndrome has been dramatically reduced. Some babies are fine if they are turned slightly to the side but you should never place the baby on his/her stomach unless you are continuously watching. The crib or bassinet should not contain any pillows, comforters or soft toys.

In general, the baby should be in one more layer than what you are wearing. This will keep them warm in winter and cool in summer. You should set your thermostat to a temperature where you feel comfortable, taking care to keep the baby out of any drafts. You can go out with the baby in the initial few weeks, but we recommend that you avoid crowded, busy areas (restaurants, malls, supermarkets) as much as possible to reduce the risk of illness. Visitors are welcome in the first 6-8 weeks, but if they are sick, they should stay away. Anyone who will be holding the baby should wash his/her hands first. In the car, the baby should always ride in a rear-facing car seat in the back seat of the car. Try to put the seat in the center-most area if possible. The baby will stay in a rear-facing car seat until age 1 year and weight 20 pounds.

Babies do many things that are normal in the first weeks of life (and more). Rarely are these signs of illness or other medical problems.

Babies breathe through their noses more than their mouths. They will often sneeze or sound like they are congested. Unless you are seeing a lot of mucous, you should not do anything. If needed, you can use 2-3 saline drops and the bulb syringe to help loosen mucous. If you are concerned that the baby is having trouble breathing, please see your doctor and have the baby checked.

These are common problems that are difficult to solve. Sometimes more frequent burping and propping the baby upright after feeds can help. Many babies get relief from using the infant gas drops. If the baby is spitting up large amounts or having long episodes of crying, notify your doctor.

The amount that babies can poop can be very variable. Initially, many babies will have a bowel movement with every feeding. Bowel movements are usually a yellow-green, seedy consistency. Over time, many babies only go once per day. Breast-fed babies sometimes only poop once or twice per week. As long as the stools are soft and the babies is not crying each time, this is normal. If the baby is constipated, your doctor can give you suggestions on how to help.

These are a sign of withdrawal from maternal hormones. Breast area in males and females can be swollen and may even show milk discharge. Girls can have mucousy or blood-tinged vaginal discharge. This is normal and will go away on its own.

If a baby gets an infection in the first 8 weeks of life, it can be a medical emergency. Call your doctor if your baby: 1) refuses to feed for more than 6 hours, 2) becomes very irritable or cries inconsolably for several hours, 3) has a fever of 100.6 or greater by rectal thermometer. Again, for any questions, concerns or issues, please call our office at (845)-483-5852 (Poughkeepsie), (845)-896-4505 (Fishkill) and speak to a nurse or doctor as soon as possible.