WELL CHILD CARE AT 2-4 DAYS



BRIAN W. CARLSON, M.D.

Intermountain Logan Clinic

412 North 200 East

Logan, UT 84321

(435) 713-2800

WELL CHILD CARE AT 4 DAYS

Maternal Fatigue and Exhaustion

For many mothers the first weeks at home with a new baby are often the hardest of their lives. Don’t be afraid to ask for help from the baby’s father, your mother, mother-in-law, or close friends. They can help shop, cook, clean, and do laundry/dishes so you can focus on your new baby. Every baby awakens one or more times a night. Inadequate sleep will leave you fatigued. The way to avoid sleep deprivation is to go to bed earlier in the evening and nap when your baby naps during the day.

Postpartum Blues

More than half of women experience postpartum blues on the third or fourth day after delivery. Symptoms include tearfulness, tiredness, sadness, and difficulty thinking clearly. These symptoms usually clear in 1 to 3 weeks. Don’t be afraid to discuss these feelings with others. Make sure you are getting enough rest and help. Getting out of the house at least once a week is also helpful. Please contact us if you are feeling overwhelmed or stressed. If your symptoms are severe or lasting longer than 3-4 weeks please talk to your doctor about postpartum depression.

Feeding

Your baby is growing! He only needs breast milk or infant formula for good nutrition. Most babies are taking two ounces of formula every two to three hours now. Breastfed babies sometimes eat more often. Babies wake up at night to feed -- this is normal. There is no need to start cereal or baby food until your baby is six months old. Babies can have food allergies if solids are started too early. If your baby wants to feed more often, try a pacifier, he or she may need to just suck. You show love to your baby if you hold him while he eats. It is best not to prop the bottle, this may cause the baby to choke. Laying the infant flat to feed also increases the risk for ear infections.

Mixing formula: Always mix powder formula according to the directions, usually one scoop for every 2 ounces of water. Using too much or too little water for the formula can be harmful to the baby. The American Academy of Pediatrics recommends using an iron-fortified formula to decrease the risk of anemia in the first year of life. Mothers who are breast-feeding should continue to take their prenatal vitamins.

Development

Babies are learning to use their eyes and ears; smiling faces and gentle, pleasant voices are interesting for babies at this age. Babies usually sleep about 16 hours a day. It is normal for your new baby to cry some every day. Crying babies need to be held. You can’t spoil your baby during the early months of life. If your baby is crying excessively at this age, it may be from hunger if the infant is not getting enough breast milk or it could be a sign of illness. If you are concerned about the amount of crying, talk to your doctor by phone or at your next well child visit.

Sleep

It is recommended by the American Academy of Pediatrics that babies should not sleep on their stomachs. There is a relationship between Sudden Infant Death Syndrome (SIDS) and babies sleeping on their stomachs. Position the baby on its back. Side sleeping is not as safe as back sleeping but to avoid a flat spot on the back of the head a light blanket can be rolled and placed under one side of the body to tilt the infant’s body at an angle. By changing sleeping positions in this way, the risk of a flat spot on the head can be reduced. Never put your baby on a waterbed, beanbag, or anything that is soft enough to cover the face and block air to the nose and mouth. Pacifiers may help reduce the risk of SIDS and may be used once breast/bottle feeding is well established. However, if your baby doesn’t want it or if it falls out of his mouth, don’t force it.

Bowel and Bladder

Most babies will strain to pass bowel movements. Grunting and pushing with bowel movements is normal. As long as the bowel movement is soft, there is no need to worry. Ask your doctor about bowel movements that are hard (constipation). Babies usually wet the diaper at least six times a day. Frequency of stooling can range from “every time he eats” to once every three to four days. Most babies fall somewhere between the two extremes.

Infection Control

Babies under the age of 2 months are more susceptible to infection. Good hand washing is the best way to minimize the spread of infection. If a family member or friend is ill, ask them not to visit. It is a good idea to limit contact with children from other families and large groups of people (i.e. church and large family gatherings) for the first month. If anyone has a “cold sore” on their face or lips they should not be near the infant. These sores are caused by the herpes virus and spread through kissing or direct contact with the lesion. Herpes infections in newborns can be very serious. The best treatment is prevention.

Safety

Car Safety: An approved car seat is the safest way for babies to travel in cars, and Utah law requires them. Never leave your baby alone in a car; also never leave your baby unattended with young brothers or sisters or pets.

Crib Safety: If you use a crib for your baby, be sure to pick a safe location (not too close to a heater or hanging cords from blinds or lights), and make sure the side rails are always completely up. Crib slats more than 2 3/8 inches apart can lead to injuries to babies. The railing should be at least 26 inches higher than the lowest level of the mattress support, so your growing baby can’t climb over and fall. The mattress should fit snugly, so the baby’s head can’t get stuck between the mattress and the crib.

Next Visit

Unless told otherwise, your baby’s next check-up with the doctor will be when she is 2 weeks old. By this visit your child should be back to or above her birth weight. Be sure to write down any questions that come up before then so we can discuss them at your next appointment. Your infant will also have a blood test at this visit called the newborn screen which is collected by a “heel stick.”

When to call the MD

Being a new parent can be overwhelming. If you have any worries or concerns, please contact our office. Please call us if any of the following occurs:

• Rectal temperature great than 100.4

• Concerns about jaundice or rashes

• Breathing difficulties, blueness of the lips

• Persistent vomiting, concerns about dehydration

• Lethargy or irritability (persistent crying)

• Feeding difficulties

• Circumcision concerns

• Less than 3 wet diapers per day, concerns about stools

• Any other concerns that you may have

Revised 7/2008

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