Newborn Nursery Anticipatory Guidance



Newborn Nursery Anticipatory Guidance

Prevention of Sudden Infant Death Syndrome (SIDS)

• Position the infant only on the back for sleep. (not on stomach, not on side)

• Mattress should be firm

• Parents should not use bumpers, pillows, comforters, stuffed animals or large objects in the crib

• Parents should not sleep with the infant because they could roll over in their sleep.

• Pacifiers are recommended once breastfeeding is established and until 6 months of age

• Address parental smoking & cessation.

Car Seat selection and proper use

• Rear-facing infant 5-point harness car seat

• When possible, best location for car seat is the middle of the back seat (but most cars have latch system attachments only in side positions and it is always safest to have the seat wherever it can be most-properly installed)

Prevention of illness

• Everyone must wash hands or use hand sanitizer before touching the baby

• No one should kiss the infant on the mouth or the hands which he/she will put in mouth

Signs of illness

• Rectal temperature of 100.4°F (38°C) or higher

• Rectal temperature of 97 °F or below

• Signs of dehydration, lethargy, poor feeding

• Jaundice- Contact the physician if the baby’s skin looks more yellow, particularly on the extremities or abdomen or has poor feeding, lethargy, or excessive fussiness.

Properly feeding the infant

• Proper breastfeeding position, attachment, and adequacy of swallowing

• Breast feeding times should be 6 the 1st day, 8 the 2nd day and 10 from the 3rd day on.

• Breastfeeding mothers should consult their physicians before taking any new medications.

• Parents should not give their infant supplemental water or honey.

• Any infant can feed as often as needed but cannot wait > 4 hours between feeds without being offered

Urination patterns

• Use the breastfeeding guide for min voids and stools.

• Six or more wet diapers per day is normal for a breastfed infant after the mother’s milk has come in, as well as for bottle-fed infants.

Bowel movements.

• More than three bowel movements per day is normal in breastfed infants.

• Bottle-fed infants may have fewer bowel movements.

Umbilical cord care

• Most cords will fall off within the first two weeks of life.

• The cord should be kept clean and dry above diaper

• Alcohol swabs can be used to clean if the cord appears to have been soiled or oozing

Skin care

• Review of common rashes

• No lotions, creams or oils to the skin (unless recommended by doctor/PNP)

• In summer, no direct sun light 10am-4pm

Genital care

• Instruction on proper care of circumcised penis (Vaseline dressings).

• For uncircumcised penises clean well, instruct not to retract foreskin.

• Girls may have vaginal discharge and scant bleeding due to maternal hormones.

Follow-up appointment made at discharge

• Infants younger than 24 hours, follow up within 24 hours of discharge.

• Infants 24 to 48 hours of age, follow up within 48 hours of discharge.

• Infants older than 48 hours, follow up within 72-96 hours of age. (reviewed 11/2011 L.Wilks)

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