:full_moon: *In-Person After Hours Appointments Now Available* :full_moon:

**Convenient Care**
:sparkles: Evening and Weekend Pediatric Appointments, Because Illness Doesn't Keep Office Hours :sparkles:
:full_moon: *In-Person After Hours Appointments Now Available* :full_moon:

**Convenient Care**
:sparkles: Evening and Weekend Pediatric Appointments, Because Illness Doesn't Keep Office Hours :sparkles:
After Hours Scheduling Schedule
After Hours Scheduling Schedule

Bringing Baby Home: How to Prepare for the Arrival of Your Newborn

From American Academy Pediatrics:

One of the most cautious drives you’ll ever take is the one bringing your baby home with you. Newborns look and feel fragile, and they represent a new of world of uncertainty. Here’s what you need to know to make your transition to parenthood easier.

It’s true: There’s no official instruction manual for becoming a parent.

But relax. You’re not the first parent to wonder why you’ve been entrusted with a little person without an instruction manual. The 40 weeks (give or take) of pregnancy allow time for more than just picking out names; it’s your opportunity to plan and prepare. The more you know about your newborn, the better equipped you’ll be when she arrives.

Once your baby is born, doctors will be looking for a few key signs that she is healthy and ready to go home, says Vinod K. Bhutani, M.D., FAAP, professor of pediatrics at Lucile Packard Children’s Hospital at Stanford University School of Medicine. “First they will want to see that the baby is able to breathe well and maintain her body temperature,” says Dr. Bhutani, who is also a member of the American Academy of Pediatrics (AAP) Committee on Fetus and Newborn.

Newborns must also demonstrate that they can feed well. Regardless of whether she’s breastfed or bottle-fed, all babies should be wetting at least three or four diapers in a 24-hour period, says Dr. Bhutani. And while many newborns have some jaundice — a yellowish tint to their skin — their jaundice will be evaluated before they’re sent home from the hospital. If necessary, your pediatrician will discuss a follow-up plan for monitoring your baby’s jaundice.

Healthy at Home

Most healthy newborns go home after two or three days, yet the transition for parents is just beginning. “It’s OK to be a little scared — the first week after babies are born is when they’re most vulnerable,” says Dr. Bhutani. “Newborns can have multiple medical problems that if left unattended can become serious.”

Dehydration is sometimes a concern for newborn babies that can continue once they’ve left the hospital. Your pediatrician will discuss dehydration with you so you’ll know what to look for, how to respond, etc.

Parents should also watch for signs of infection in their newborn. Infections can be picked up during birth or from people other than the parents handling the baby, such as visitors. “Most people think only of fevers, but newborns can have dropping temperatures or a low temperature that’s of concern,” says Dr. Bhutani. It’s always wise to watch for signs of infection around the belly button or circumcised foreskin, such as poor sucking during breastfeeding, a lack of appetite, poor weight gain, weak crying, and increasing irritability.

Jaundice happens in most every baby, peaking in the first week as newborns learn to excrete the yellow pigment called bilirubin in their stools. “Babies tend to have slow liver function at first and may have some evidence of jaundice as their livers quickly mature over the first several days,” write Drs. Laura Jana and Jennifer Shu in Heading Home With Your Newborn. “The bilirubin level generally peaks by about 5 days for term babies and about 1 week for those born prematurely.” If your baby continues to have signs of jaundice — very yellowish skin and eyes — after day four, consult your pediatrician.

Although most babies remain perfectly healthy after they’re discharged from the hospital, it’s important to watch for any signs of illness and take your child to the pediatrician for evaluation within a day or two of leaving the hospital. “Every baby needs to be seen by a pediatrician on day three, four, or five,” says Dr. Bhutani. “It’s a must.”

Finding a Pediatrician

As a new parent, it’s important to find a pediatrician with whom you feel comfortable. If your child becomes ill, you want to have a good working relationship with a doctor you trust and respect, and who will be there to support you.

Begin by evaluating the pediatrician practices in your local area. Determine whether it matters to you if you have a male or female pediatrician. Be aware that while it’s all the same to infants, some children as they get older feel more at ease working with a doctor of the same sex. If possible, visit the offices and meet the physicians in person. Or find out if your hospital has a “Meet the Doctors” night attended by area pediatricians.

Since you’ll be visiting a pediatrician shortly after bringing your child home, don’t leave this task until the last minute. “You have nine months to plan. You should always choose your pediatrician beforehand,” says Dr. Bhutani.

Quick Tips: Time to Call the Doctor

Watch for these signs that it’s time to call your pediatrician:

  • Your newborn’s breathing is faster or irregular
  • You notice blueness or a darkness on the lips or face 
  • Your newborn has a fever 
  • Your newborn’s body temperature has dropped
  • You see signs of dehydration (less than 3 to 4 wet diapers in a 24-hour period)
  • Your baby’s belly button or circumcision area looks infected
  • Your newborn’s jaundice does not decrease by the fifth day 
  • Your baby is crying a lot or appears sluggish
  • You think your baby is not looking or feeling well

Quick Tips: Choosing a Pediatrician

The following are a few questions from the AAP to help you select a pediatrician:

  • What are the office hours? Is emergency coverage available 24/7?
  • Which hospital does the pediatrician use?
  • Do they accept your insurance plan and how does the office process billing and claims?
  • What are the qualifications of the pediatrician? Is he or she an AAP member (i.e., “FAAP,” a Fellow of the American Academy of Pediatrics)?

Newborns and COVID-19

From American Academy Pediatrics:

Congratulations on the birth of your new baby! And kudos for getting fully immunized against COVID-19 during your pregnancy. This protects you—and also passes along protective antibodies that may reduce your baby’s risk of COVID-19 infection. In other words, you likely gave your little one some immunity against SARS-CoV-2, the virus that causes COVID-19, from the moment they were born!

Still, you should strongly consider limiting your newborn’s exposure to others. People who aren’t vaccinated against COVID-19 spread the virus, especially the more contagious Delta variant. Also keep in mind that people aren’t fully vaccinated against COVID-19 until two weeks after the last shot.
How likely are newborns to get sick from COVID?

While serious COVID-19 infections in newborns are uncommon, some babies in this age group have become severely ill. Your baby’s overall fragile immune system, as well as their small airways, developing lungs and breathing muscles leave them more vulnerable to all respiratory diseases, including COVID.

When young infants do get COVID or other airborne illnesses, it’s often because a close contact transmitted it to them. This can happen even if the person or contact doesn’t feel sick.Ways to protect your baby from the virus

  • Face masks. Non-household members over age 2 should mask-up, even if visiting the baby outside or in small gatherings.
  • Physical distancing. Even though everyone wants to hold a new baby, you should insist unvaccinated visitors remain at least 3 feet from the baby. These measures should also be kept in mind when you go out of the house with the baby.
  • Keep visits with your baby short. Also, limiting visits to under 15 minutes may also reduce your infant’s risk of becoming infected with COVID-19.
  • Vaccines. Encourage family members and friends who are eligible for COVID-19 vaccines to get fully vaccinated.

Remember

Having a new baby is a wonderful but exhausting time. Taking these common-sense steps can give you peace of mind that you are reducing your baby’s risk of COVID-19 infection. Vaccine trials are underway in infants 6 months of age and older. Keeping your baby up-to-date on all recommended vaccines is one of the most important ways to protect your baby’s health.

How to Calm a Fussy Baby: Tips for Parents & Caregivers

From the American Academy of Pediatrics;

Here are ways you can try to comfort a crying baby. It may take a few tries, but with patience and practice you’ll find out what works and what doesn’t for your baby. 

  • Swaddle your baby in a large, thin blanket (ask your nurse or child’s doctor to show you how to do it correctly) to help her feel secure.
  • Hold your baby in your arms and place her body on her left side to help digestion or stomach for support. Gently rub her back. If your baby goes to sleep, remember to always lay her down in her crib on her back.
  • Turn on a calming sound. Sounds that remind babies of being inside the womb may be calming, such as a white noise device, the humming sound of a fan, or the recording of a heartbeat.
  • Walk your baby in a body carrier or rock her. Calming motions remind babies of movements they felt in the womb.
  • Avoid overfeeding your baby because this may also make her uncomfortable. Try to wait at least 2 to 2½ hours from the beginning of one feeding to the next.
  • If it is not yet time to feed your baby, offer the pacifier or help your baby find her thumb or finger. Many babies are calmed by sucking.
  • If food sensitivity is the cause of discomfort, a change in diet may help.
    • For breastfed babies: Moms may try changing their own diet. See if your baby gets less fussy if you cut down on milk ­products or caffeine. If there is no ­difference after making the dietary changes, resume your usual diet. Avoiding spicy or gassy foods like onions or ­cabbage has worked for some moms, but this has not been ­scientifically proven.
    • For bottle-fed babies: Ask your child’s ­doctor if you should try a different for­mula. This has been shown to be helpful for some babies.
  • Keep a diary of when your baby is awake, asleep, eating, and crying. Write down how long it takes your baby to eat or if your baby cries the most after eating. Talk with your child’s doctor about these behaviors to see if her crying is related to sleeping or eating.
  • Limit each daytime nap to no longer than 3 hours a day. Keep your baby calm and quiet when you feed or change her during the night by avoiding bright lights and noises, such as the TV.

Checklist for What Your Baby May Need:

Here are some other ­reasons why your baby may cry and tips on what you can try to meet that need.  If your baby is… 

  • Hungry. Keep track of feeding times and look for early signs of hunger, such as lip-smacking or ­moving fists to his mouth.  
  • Cold or hot. Dress your baby in about the same ­layers of clothing that you are wearing to be comfortable. 
  • Wet or soiledCheck the diaper. In the first few months, babies wet and soil their diapers a lot. 
  • Spitting up or vomiting a lot. Some babies have symptoms from gastroesophageal reflux (GER), and the fussiness can be confused with colic. Contact your child’s doctor if your baby is fussy after feeding, has excessive spitting or vomiting, and is losing or not gaining weight.  
  • Sick (has a fever or other illness). Check your baby’s temperature. If your baby is younger than 2 months and has a fever, call your child’s ­doctor right away. See Fever and Your Baby for more information.  
  • Overstimulated. 
  • Bored. Quietly sing or hum a song to your baby. Go for a walk. 

Why Parents & Caregivers Need Breaks from Crying Babies:

If you have tried to calm your crying baby but nothing seems to work, you may need to take a moment for yourself. Crying can be tough to handle, especially if you’re physically tired and mentally exhausted.

  • Take a deep breath and count to 10.
  • Place your baby in a safe place, such as crib or playpen without blankets and stuffed animals; leave the room; and let your baby cry alone for about 10 to 15 minutes.
  • While your baby is in a safe place, consider some actions that may help calm you down.
  • Listen to music for a few minutes.
  • Call a friend or family member for ­emotional support.
  • Do simple household chores, such as vacuuming or washing the dishes.
  • If you have not calmed after 10 to 15 minutes, check on your baby but do not pick up your baby until you feel you have calmed down.
  • When you have calmed down, go back and pick up your baby. If your baby is still crying, retry soothing measures.
  • Call your child’s doctor. There may be a medical reason why your baby is crying.
  • Try to be patient. Keeping your baby safe is the most important thing you can do. It is normal to feel upset, frustrated, or even angry, but it is important to keep your behavior under control. Remember, it is never safe to shake, throw, hit, slam, or jerk any child—and it never solves the problem!

Starting Solid Foods

From the American Academy of Pediatrics;

Rice, oatmeal, or barley? What infant cereal or other food will be on the menu for your baby’s first solid meal? Have you set a date?

At this point, you may have a plan or are confused because you have received too much advice from family and friends with different opinions.

Here is information from the American Academy of Pediatrics (AAP) to help you prepare for your baby’s transition to solid foods.

When can my baby begin solid foods?

Remember that each child’s readiness depends on his own rate of development.

  • Can he hold his head up? Your baby should be able to sit in a high chair, a feeding seat, or an infant seat with good head control.
  • Does he open his mouth when food comes his way? Babies may be ready if they watch you eating, reach for your food, and seem eager to be fed.
  • Can he move food from a spoon into his throat? If you offer a spoon of rice cereal, he pushes it out of his mouth, and it dribbles onto his chin, he may not have the ability to move it to the back of his mouth to swallow it. That’s normal. Remember, he’s never had anything thicker than breast milk​ or formula before, and this may take some getting used to. Try diluting it the first few times; then, gradually thicken the texture. You may also want to wait a week or two and try again.
  • Is he big enough? Generally, when infants double their birth weight (typically at about 4 months of age) and weigh about 13 pounds or more, they may be ready for solid foods.

NOTE: The AAP recommends breastfeeding as the sole source of nutrition for your baby for about 6 months. When you add solid foods to your baby’s diet, continue breastfeeding until at least 12 months. You can continue to breastfeed after 12 months if you and your baby want to. Check with your child’s doctor about the recommendations for vitamin D and iron supplements during the first year.https://www.youtube.com/embed/MKcKS9HxLTk

How do I feed my baby?

Start with half a spoonful or less and talk to your baby through the process (“Mmm, see how good this is?”). Your baby may not know what to do at first. She may look confused, wrinkle her nose, roll the food around inside her mouth, or reject it altogether.

One way to make eating solids for the first time easier is to give your baby a little breast milk, formula, or both first; then switch to very small half-spoonfuls of food; and finish with more breast milk or formula. This will prevent your baby from getting frustrated when she is very hungry.

Do not be surprised if most of the first few solid-food feedings wind up on your baby’s face, hands, and bib. Increase the amount of food gradually, with just a teaspoonful or two to start. This allows your baby time to learn how to swallow solids.

If your baby cries or turns away when you feed her, do not make her eat. Go back to breastfeeding or bottle-feeding exclusively for a time before trying again. Remember that starting solid foods is a gradual process; at first, your baby will still be getting most of her nutrition from breast milk, formula, or both. Also, each baby is different, so readiness to start solid foods will vary.

NOTE: Do not put baby cereal in a bottle because your baby could choke. It may also increase the amount of food your baby eats and can cause your baby to gain too much weight. However, cereal in a bottle may be recommended if your baby has reflux. Check with your child’s doctor.

​Which ​​food should I g​ive my baby first?​Your baby’s first foods are your choice. Whether you decide to make your own baby food or buy premade baby food, you have many options. However, keep the following in mind:Foods should be soft or pureed to prevent choking​.Introduce one “single-ingredient” new food from any food group every 3 to 5 days. Look out for any reactions.There is no evidence that waiting to introduce baby-safe (soft) foods, such as eggs, dairy, soy, peanut products, or fish, beyond 4 to 6 months of age prevents food allergy. However, testing for peanut allergy is recommended for babies with severe eczema and/or egg allergy. Check with your child’s doctor about how and when to give peanut products.There is no evidence that your baby will develop a di​​slike for vegetables if fruit is given first.
Be sure to include foods that provide iron and zinc, such as baby food made with meat or iron-fortified cereals.​If you feed your baby premade cereal, make sure it is made for babies and is iron fortified. Baby cereals are available premixed in individual containers or dry, to which you can add breast milk, formula, or water.Within a few months of starting solid foods, your baby’s daily diet should include a variety of foods, such as breast milk, formula, or both; meats; cereal; vegetables; fruits; eggs; and fish.​

When can I give my baby finger foods?

Once your baby can sit up and bring her hands or other objects to her mouth, you can give her finger foods to help her learn to feed herself. To prevent choking, make sure anything you give your baby is soft, easy to swallow, and cut into small pieces. Some examples include small pieces of banana, wafer-type cookies, or crackers; scrambled eggs; well-cooked pasta; well-cooked, finely chopped chicken; and well-cooked, cut-up potatoes or peas.

At each of your baby’s daily meals, she should be eating about 4 ounces, or the amount in one small jar of strained baby food. Limit giving your baby processed foods that are made for adults and older children. These foods often contain more salt and other preservatives.

If you want to give your baby fresh food, use a blender or food processor, or just mash softer foods with a fork. All fresh foods should be cooked with no added salt or seasoning. Although you can feed your baby raw bananas (mashed), most other fruits and vegetables should be cooked until they are soft. Refrigerate any food you do not use, and look for any signs of spoilage before giving it to your baby. Fresh foods are not bacteria-free, so they will spoil more quickly than food from a can or jar.

NOTE: Do not give your baby any food that requires chewing at this age, or any food that can be a choking hazard. Foods to avoid include hot dogs (including meat sticks, or baby food “hot dogs”); nuts and seeds; chunks of meat or cheese; whole grapes; popcorn; chunks of peanut butter; raw vegetables; fruit chunks, such as apple chunks; and hard, gooey, or sticky candy.

What changes can I expect after my baby starts solids?

When your baby starts eating solid foods, his stools will become more solid and variable in color. Because of the added sugars and fats, they will have a much stronger odor, too. Peas and other green vegetables may turn the stool a deep-green color; beets may make it red. (Beets sometimes make urine red as well.) If your baby’s meals are not strained, his stools may contain undigested pieces of food, especially hulls of peas or corn, and the skin of tomatoes or other vegetables. All of this is normal. Your baby’s digestive system is still immature and needs time before it can fully process these new foods. If the stools are extremely loose, watery, or full of mucus, however, it may mean the digestive tract is irritated. In this case, reduce the amount of solids and introduce them more slowly. If the stools continue to be loose, watery, or full of mucus, talk with your child’s doctor to find the reason.

Should I give my baby juice?

Babies do not need juice. Babies younger than 12 months should not be given juice. After 12 months of age (up to 3 years of age), give only 100% fruit juice and no more than 4 ounces a day. Offer it only in a cup, not in a bottle. To help prevent tooth decay, do not put your child to bed with a bottle. If you do, make sure it contains only water. Juice reduces the appetite for other, more nutritious, foods, including breast milk, formula, or both. Too much juice can also cause diaper rash, diarrhea, or excessive weight gain.

Does my baby need water?

Healthy babies do not need extra water. Breast milk, formula, or both provide all the fluids they need. However, it is OK to offer a little water when you begin to give your baby solid foods. Use an open, sippy or strawed cup and limit water to no more than 1 cup (8 ounces) each day. Also, a small amount of water may be needed in very hot weather. If you live in an area where the water is fluoridated, drinking water will also help prevent future tooth decay.

Good eating habits start early

It is important for your baby to get used to the process of eating—sitting up, taking food from a spoon, resting between bites, and stopping when full. These early experiences will help your child learn good eating habits throughout life.

Encourage family meals from the first feeding. When you can, the whole family should eat together. Research suggests that having dinner together, as a family, on a regular basis has positive effects on the development of children.

Remember to offer a good variety of healthy foods that are rich in the nutrients your child needs. Watch your child for cues that he has had enough to eat. Do not overfeed!

If you have any questions about your child’s nutrition, including concerns about your child eating too much or too little, talk with your child’s doctor.

5 Secrets to a Smarter Baby: School Readiness Can Start Now

From the American Academy of Pediatrics;

As parents, we all want happy, healthy babies. Not only that, we want them to be smart.

Growing research in early brain development shows there are some basic things you can do right now to start raising a child who is curious about the world and ready to learn. These early education activities we’re talking about are simple―and screen free!

The American Academy of Pediatrics (AAP) recommends parents talk with their pediatrician about how to create a supportive, stimulating environment for their baby―starting at birth―that promotes healthy brain development and builds the social and emotional skills necessary for school readiness.

Use the “5 Rs of Early Education” in your daily activities right from birth:

1. READ together as a daily, fun, family activity. 

  • The AAP recommends this to build language, literacy, and social-emotional skills that last a lifetime. It’s never too young to start reading with your baby. Reading to your child, research suggests, boosts activity in parts of the brain that form the building blocks of language, literacy skills and imagination.

2. RHYME, play, talk, sing, and cuddle together often throughout the day. 

  • The AAP encourages parents to use play to help meet their child’s health and developmental milestones, beginning from birth. Need ideas? Here are some great ways to do this based on your child’s age. Talk with them about things they see around them, at home, at the store, or while traveling. Enroll in quality early education programs and activities, take time to visit a children’s museum or local library, and enjoy story time.

3. Build ROUTINES for meals, play, and sleep. 

  • This helps children know what to expect and what is expected of them. Brush, Book, Bed, for example, is a great way to structure your child’s nighttime routine. Eating at least three family meals together each week is associated with healthier kids, according to a study published in Pediatrics. 

4. REWARD everyday successes (especially for effort toward goals like helping others).

  • Catch your child doing something good and praise them for it! Praise from those closest to a child is a very powerful reward. Talk with your pediatrician about how to shape and manage your child’s behavior, model the good behavior, and reinforce it by using positive discipline techniques that build a child’s self-regulation skills. Your child’s social, emotional, and behavior skills are equally critical to school success.

5. Develop RELATIONSHIPS that are nurturing, respectful, and consistent.

  • A strong parent-child relationship helps protect against the lasting effects of adverse childhood experiences (ACEs), traumatic situations that can lower a child’s chance of doing well in school. As you strive to teach your child about healthy relationships and choosing friends wisely, don’t forget to model them in your own life. Demonstrating good relationships skills with your spouse or partner, and taking time to nurture close friendships with others, is as important as simply talking about these skills–if not more so.

You are your baby’s best teacher.

A certain toy is not necessary for your child to reach his or her next developmental milestone. There is no one app that will teach your child to read. While it’s easy to fall victim to the marketing, YOU are what your child needs to start on the path toward school readiness with daily reading, rhyming, routines, rewards, and relationship building.