Expectant Mothers: What You Need to Know

From infancy through the teenage years, your pediatrician or pediatric nurse practitioner will not only treat your child’s acute and chronic illnesses, but they’ve been specially trained to also monitor your child’s emotional, social, and physical health by following a set of comprehensive health guidelines developed by the American Academy of Pediatrics (AAP). These screenings and assessments (“well-child care”) follow a set schedule that coincide with recommended childhood vaccines. Benefits of visiting a pediatric office for well-child care visits include:

• Tracking growth and development. See how much your child has grown in the time since your last visit and talk with your pediatric healthcare provider about your child's development. You can discuss your child's milestones, social behaviors, and learning, among other things.
• Prevention. Your child gets scheduled immunizations to prevent debilitating and potentially fatal diseases and illnesses. You can also ask about nutrition and safety in the home and at school.
• Raising concerns. Make a list of topics you want to talk about, such as development, behavior, sleep, eating, or getting along with other family members. Bring your top questions or concerns with you to talk about with your pediatric healthcare provider.
• Team approach. Regular visits create strong, trustworthy relationships between children, parents, and their pediatrician or pediatric nurse practitioner. The AAP recommends well-child visits as a way for pediatric healthcare providers and parents to serve the needs of children. This team approach helps develop the optimal physical, mental, and social health of a child.

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• It should meet the Consumer Product Safety Commission’s (CPSC) standards. Most times it’s written on the box. Please keep in mind that the CPSC has banned drop-down-sides on cribs. Check for recalls on nursery products at SaferProducts.gov.
• Wooden surfaces should be free of splinters/cracks and have lead-free paint.
• Slats should be no more than 2 inches apart.
• Sides should have no crossbars.
• Sides should have a hand-operated, locking latch to prevent accidental release.
• Mattress should be firm, and its size should fit the crib precisely enough to allow no more than 2 finger width between the mattress and the crib.
• Minimum rail height of 22 inches (from the top of the rails to the top of the mattress when the mattress is at the lowest setting).
• Bumpers should be tied tightly with ties that are no longer than 6 inches.
• Don’t use pillows, comforters, stuffed animals, or lambskin material in the crib.
• Keep mobiles out of baby’s reach.
• Position crib away from windows, electrical outlets, curtain cords, mini-blinds and/or other window coverings. Make sure mini-blind cords are secured near the top of the window away from baby’s reach.

If they are still blue at 6 months of life, they will most likely stay blue. If they are already changing color by 3 months, they more than likely will not stay blue.

It’s common for newborn eyes to cross sometimes. By 4-months of age the eyes should have stopped crossing. If they haven’t, call your pediatrician.

In the first week of life, a newborn should feed on average of every 3 hours. For breastfeeding mothers, to ensure your breast milk supply comes in, it’s encouraged that you breast feed every 3 hours (or sooner) to get enough stimulation needed to make the milk. If you formula feed, you may not want to go longer than every 4 hours between feedings during the first week of life.

• A rule of thumb is that the number of wet diapers per day should be equal to the age of your baby in number of days during the first week or so of life. So for example, a 3-day old baby should have 3 wet diapers in 24 hours. After they are 6-days old, babies should have at least 6 wet diapers daily. 
• Bowel movements differ a great deal. Some babies poop a lot while others may poop every other day or so. As long as it’s soft, don’t be alarmed. If it has been more than 48 hours since your baby has had a dirty diaper (a diaper with poop in it), call your pediatrician.

There is no need to give more water to a baby as long as you breastfeed or prepare formula with water as directed. Water by itself may actually be harmful to your baby. Electrolytes in the baby’s body are very sensitive to changes in the amount of water in a baby’s body. Since a baby is so small, pediatricians cannot safely recommend how much water a baby can drink. Any amount can upset the balance between electrolytes and water, which could lead to seizures. A baby should never be given Gatorade or Pedialyte without consulting a pediatrician. Once your baby is 4-months old, your pediatrician might allow up to 2 ounces of water daily. 

Karo Syrup (corn syrup) and honey may have spores that can cause botulism. It is safest to wait until after your child turns one year old before giving honey or corn syrup.

 It is normal for babies to lose up to seven percent (7%) of their birth weight in the first 3-5 days of life. They should then start gaining about one ounce a day and reach their original birth weight by 10-14 days of life. Your milk supply will come in around the third day. To make sure this happens, make sure your baby is latching on well every 3 hours. Once your milk supply comes in, your baby will give you cues, or show you he/she is finished. Your baby should be happy after feedings and wet their diapers as expected. After the first week, your baby should wake up on his/her own for feedings.

It should fall off during the first 2 weeks of life. Until then you need to clean it, keep it dry, and give sponge baths only! The sooner it falls off and remains dry, the sooner you can give your baby a bath in a basin. If it doesn’t fall off by 1 month, call your pediatrician.

 You can give baths daily. Start with sponge baths until the cord falls off and then proceed to “real baths.” Bath time can be an excellent opportunity to not only wind down at the end of the day, but it is also an excellent way to incorporate touching and massaging – both of which are good for your baby.

The American Academy of Pediatrics has recently changed its position on circumcision. Before, they used to endorse circumcisions, and now they neither encourage nor discourage them. Your decision might be based on religious/cultural reasons, or simply on your preference. Pediatricians should support your decision, whichever you decide.

A rectal temperature of 100.5 degrees F or higher is considered a fever. Rectal temperatures are the most reliable. If your baby feels warm, be sure to unbundle them from blankets and check a rectal temperature a few minutes later. Call your pediatrician if the temperature is above 100.4 degrees F.

Babies should be placed on their backs to sleep. This is because it reduces the risk of Sudden Infant Death Syndrome (SIDS). 

Other things to do are: provide a firm mattress, avoid over-wrapping the baby, avoid putting fluffy blankets, stuffed animals/toys, or bottles in the bed/crib, avoid smoking in the house and car*, and be extra careful when co-sleeping or just avoid it until the baby is older. Sleep positioners are no longer considered safe.

*Even if you smoke outside, tie your hair back if you have long hair and change your shirt or jacket before holding your baby. 

Almost all babies need some non-nutritive sucking (sucking only, not feeding). It provides a way for them to relax and to feel secure. Keep in mind that pacifiers provide no advantage over sucking the thumb, except that giving a baby a pacifier is under the parents’ control. Sucking the thumb or a pacifier after the age of four can lead to your child’s teeth being crooked. It’s your choice whether or not to use a pacifier. You should also know that babies who suck on pacifiers may swallow a lot of air. This may lead to more spitting up and/or more gas. The real answer is to use pacifiers with caution and as needed, but try not to let it become a habit. Some studies have also shown that some pacifier use may have a protective role in decreasing the incidence of SIDS.

You can start even while you’re pregnant! Talk, read, and sing to your baby, even though you may not know the sex or the name, yet. Babies can hear you while inside, and hearing your voice can be soothing and reassuring. Why not regularly read some of your bedtime favorites and then read those same bedtime stories after the baby is born? Read often, but especially after bath-time or as part of your evening ritual for bedtime. It doesn’t even matter what you read so long as it isn’t upsetting to you. Babies may learn to associate your voice and reading time with sleep. Once they do, they expect the same routine. Meeting their expectations by keeping the routine makes them feel more secure. This may also help to lessen their dependence on feeding or other soothing activities to fall asleep. Use music to stimulate your baby as well, but make sure you don’t over-stimulate them.

Direct sun on your baby during the first year of life can be harmful, and we generally advise to avoid going out at all in the direct sun for the first 6 months of life. Sun exposure over the years and/or sunburn at an early age increases your chance for getting skin cancer. To reduce exposure, avoid the peak hours of sunlight (10 a.m. - 4 p.m.) when it is the hottest. If you must go out, provide shade and proper covering, especially during the first 3 months of life when sunscreens are generally not recommended. After 3-6 months of life, you may apply sunscreen. Use PABA-free sunscreen with SPF 30 or above. Reapply if needed and wash off when going inside. 

Keep in mind that having some sun exposure can be good. It helps babies, older children and adults make Vitamin D in their body. Vitamin D is important for strong and healthy bones.

Do not buy baby walkers or baby bouncers. These can be dangerous and lead to injury. Use common sense when purchasing baby products. For example, if it looks and acts like a bungee cord – don’t buy it!

Though this is more of a personal choice, there are some suggestions: 

• Avoid crowded spaces.
• Avoid places with second hand smoke (homes with heavy smokers, restaurants, bars, pool halls).
• You should be able to go out and run errands. It feels good to get out of the house. Just don’t expect to get all of your errands done in one day!

Short car trips are fine from the day your leave the hospital. Airline travel can be done as early as 1 week of life, but it’s probably best to wait till your baby is at least 4-6 weeks old. Recycled air in airplanes and the crowded airports and airlines can present germs during the most vulnerable time of your baby’s life (the first 6 weeks).

Go with your instincts. If you think something might be wrong, then call. Reassurance is often the best medicine. Some other reasons to call are: 

  a) If you cannot calm, comfort or soothe your baby.

  b) Your baby seems to have a hard time breathing.

  c) Your baby has a rectal temperature of 100.5 degrees F or higher. 

  d) Your baby is not eating at least every few hours or has a hard time feeding. 

  e) Your baby looks more and more yellow (jaundiced) down to the belly button or lower.

Sunshine Pediatrics has been providing medical services to children in the Rock Hill area for twenty years now, and there’s one thing that holds as true today as it did when we opened:

Parenting is hard! It’s probably the one thing you don’t necessarily get better at with experience. Just know that you’re not alone.

Not only will we care for your child’s medical needs, but we’re also the first stop in evaluating their social, emotional, and developmental growth. Part of providing that care is knowing that your own health and well-being can impact your child. Stress is not your friend.

Regardless of how your parenting journey unfolds, we aim to stand beside you as experts in our field, a source of reassurance for your parenting concerns, and a healthcare provider you can trust. Here are 12 helpful tips we wanted to share with you. We hope your journey is a healthy one!

1. Things may not go as planned—and that’s okay.

2. Don’t be afraid to say ‘YES’ to offered help.

3. Breastfeeding can be hard, so don’t hesitate to get help. And if you can’t breastfeed, formula is not the enemy!

4. Find support with other parents.

5. It’s normal for the relationship with your partner to be strained.

6. Babies don’t need much! Love, food, sleep, clean diapers, and regular visits to their pediatrician top the list.

7. It might take 6 months to begin to normalize.

8. It’s okay to cry. If it gets to be too much, don’t hesitate to talk to a doctor. Port-partum depression is real.

9. Don’t feel guilty for wanting ‘adult’ time. It will help you recharge and make you a more patient parent.

10. Stop comparing!

11. Listen to your mommy instincts.

12. Bonding with baby may take time—and that’s okay too.