The FirsT Few weeks
For NewborNs aNd Their Families
T
By Frank Briglia, M.D.
Medical Director of The Children’s Center
at Chilton Medical Center
he birth of a baby has to be the most exciting time for a
family. It can also be overwhelming, especially for first-
time parents who do not have the experience in caring
for newborns.
There are hundreds of manuals, reference books, and internet
information that detail how best to care for a new-born in the
first few weeks of life and during infancy. Even Disney has pub-
lished a two-volume encyclopedia on baby and childcare, which is
actually quite a good reference set.
The following, however, is a list of recommendations that I
think will ensure excellent care for newborns and infants, and at
the same time alleviate some of the fears parents may have that
they are not doing all they should in caring for their newborn.
1
Select a hospital or birth center that is designat-
ed a Baby-Friendly facility. A list of facilities can be
found on babyfriendlyusa.org, along with information that is
considered by many to be the “gold standard of care.” The
Maternity Center at Chilton Medical Center, for example, is a
designated a Baby-Friendly hospital. To obtain this designation,
several criteria have to be met, including having expert nursing
staff that offer hands-on lessons in feeding, bathing, and changing
babies. This professional help is invaluable to parents, especially
when newborns room-in with mothers at a designated site, giving
parents and babies an opportunity to establish a routine of care
that can be carried over to home after discharge.
2
Breast-feed your baby. A huge part of the care routine
is the feeding of newborns, and a focus on the value of
breastfeeding should not be underestimated. Baby-Friendly
facilities offer tremendous support to help mothers succeed in
breast-feeding their newborns. Breast milk, including the thin,
watery substance called colostrum, which is produced in the first
few days after birth, has been shown to have the right balance of
fluids and nutrition that a new-born needs along with the protec-
tive immunity that only breast milk provides. For these reasons,
all mothers should attempt to breastfeed their infants.
3
Pay attention to your baby’s weight changes.
Whether one breast or bottle-feeds or uses some combina-
tion of both, a newborn needs to feed every few hours for
adequate nutrition and hydration. Since most newborns may lose
up to 10 percent of their birth weight in the first few days after
birth, which is mostly water weight loss, parents should check the
adequacy of a baby’s oral intake by monitoring the frequency of
wet and soiled diapers. They also should make note of what the
discharge weight is for the baby when leaving the birth facility. A
newborn will usually regain their birth weight one to two weeks
after birth and should be monitored by a pediatrician closely if
this is not the case.
4
Vaccinate your baby. Before discharge from the facility
where your baby is born, you should start the vaccination
schedule approved by the American Academy of Pediatrics
and have the Hepatitis B vaccine administered at the time of
birth. Despite media reports to the contrary, vaccinations have
proven to be an important method in protecting your newborn
from many infant and childhood diseases. These vaccinations
should continue throughout infancy and childhood.
5
Keep follow-up appointments with your pediatri-
cian. Your first appointment with the pediatrician is critical
and should be made within the first week of life for your
newborn. At your first visit, your physician will check many
things on your baby including the baby’s cord stump, which
should be cleaned carefully with a cotton ball dipped in alcohol
and which should fall off naturally by itself in about 10 days; your
infant’s skin color and the possibility of jaundice which may
require a bilirubin level; as well as a complete physical exam,
including the normal reflexes seen in newborns. At this visit, you
will also have the opportunity to discuss feeding and sleeping pat-
terns of your new-born. Subsequent routine pediatric visits are
recommended according to a schedule set forth by the American
Academy of Pediatrics that usually occur at one month, two, four,
and six months, and at ages 9 and 12 months.
All things considered, parents will quickly discover the tem-
perament of their newborn — parents may have a calm and even-
tempered newborn who sleeps normally two-thirds of the day,
while others will have a fussier infant who is up most of the night.
Both are normal, although the latter will require adjustments by
parents in responding to their newborn baby’s cues for care. For
example, crying infants do not always need to be fed. They may
be fatigued, may need to have a diaper change, or may be uncom-
fortable in a certain position; or they may have a condition called
reflux associated with “newborn colic,” which may need further
evaluation. A parent should not hesitate to call the pediatrician for
advice or reassurance if this comes up.
No matter what the temperament of your newborn or how
easy or difficult it is to care for your baby, parents should not hesi-
tate to turn to family members and friends for help in the first
few weeks after their baby is born. Providing the proper care for
newborns is exhausting for parents who try to go it alone. Letting
others help with dinners, laundry, shopping, etc. will give parents
more time to spend with their newborn and enjoy the many
rewards of watching their newborn develop. ❖
holiday 2018 Chilton Magazine