NUTRITION:
BREASTFEEDING – At this point, your milk should be coming in and your breasts may be engorged.  The baby should be getting better at latching on and draining the milk from your breasts.  Many babies are not feeding on a schedule and will want to eat at irregular intervals.  You will know that your child is getting enough if the baby continues to urinate at least 4 times a day and stool regularly.  Babies get most of their feeds in the first 5 minutes so try to eliminate marathon feeds (more than 30 minutes total) and offer something else for your baby to suck on if s/he is still looking to suck.  Remember, you are still eating for two, to maintain a diet that has a variety of foods, lots of fluids and at least 500 extra calories.

BOTTLE FEEDING – We encourage you to use a formula that is fortified with iron.  The iron will not make your baby constipated.  Mix your formula with tap water so that the baby will get fluoride.  If your water source is a well, we suggest boiling your water for at least one minute and then allowing it to cool before preparing the bottles.  In this day, it is not necessary to sterilize your bottles; a run through the dishwasher is adequate.

SAFETY:

  1. Always put the baby in a car seat while driving!  Your baby should be facing backward in the center of the back seat.  Never place a car seat in the front seat if there is a passenger seat airbag.  Be sure to use the locking clip if you ever place the car seat in a position that has a lap-shoulder belt.
  2. A standard firm infant mattress with no more than a thin covering such as a sheet or rubberized pad should be used.
  3. Be careful leaving toddlers and pets alone with the baby.  Their actions are too unpredictable to be safe.
  4. Now is a good time to check the smoke detectors in your home and make sure that your hot water heater is set at 120 degrees Fahrenheit.
  5. Babies should always sleep on their backs.

COMMON CONCERNS:
CARE OF THE SKIN – Sponge bathe the newborn until the umbilical cord falls off and the cord area looks normal.  The base of the cord looks yellow and is slightly wet before and after the cord falls off; there may be some blood staining.  Clean the diaper area with warm water after bowel movements.  Baby wipes can be irritating to the skin – avoid them if your baby seems sensitive.

FEVER – Any temperature elevation of 100.4 or greater rectally in an infant less than 3 months of age is of concern to us and we should be notified.  The most accurate way to measure the temperature in an infant is by the rectal method.  This is done by inserting the tip of a lubricated thermometer about ¾ of an inch into the rectum for three minutes with the baby lying on his back.  Ask for a demonstration if you are uneasy.

TODAY’S IMMUNIZATIONS:
Hepatitis B – If your child did not receive their initial Hepatitis B vaccine in the hospital, we recommend they start the vaccine series as early as possible to remain on schedule. Less than twenty percent of babies will feel any effects from today’s shot. If the baby has a fever, cries excessively, or has any unusual behavior, please call us.

NEXT VISIT:
Your baby’s next routine visit is at 2 weeks of age.