Congratulations on your new baby. We appreciate you choosing our practice and will work closely with you through out the years. Learning basic baby care will be an ongoing process not limited to a one or two hour instructional session. Each of your well baby visits will be an important part of that learning process. Following your hospital stay, we will generally see your baby within 24 hours of discharge. We welcome calls to answer any questions or concerns that may arise.
All babies are different; here are some common newborn characteristics and behaviors that you may see with your baby. So as you are counting all the fingers and toes, and making sure all the parts are where they should be, here are some things that you may note.
Soft spot: The anterior fontanel is a diamond shaped soft area at the top of the skull. It may pulsate, so don’t worry and should close between 6 to 8 months.
Caput/Cephalohematoma: Fluid filled swelling on the top of the scalp. This will usually will go away within a few days to months after birth.
Ears: a pit of dimple in front of the ear is not uncommon. Rarely these may get infected, so call us if you see redness or swelling. Also, the ears may be soft and folded over but will eventually assume their normal shape.
Eyes: Eyelids may be swollen for the first three days. The white of the eye may have a red colored hemorrhage on it. This usually resolves within a few weeks. At times, your infants’ eyes may look occasionally cross-eyes in the first few months. Call us if this persists.
A newborn can see, though focusing ability is poor. The optimal range is about 10 inches, which usually is the distance between a nursing baby and the mother’s face.
After birth your baby is alert and will look right at you. He or she will communicate readiness to feed by moving hands towards the mouth, making small mouth and tongue movements, and body movements.
Watery eyes: This may be a blocked tear duct. Most of these resolve within one year. Call us if there is a lot of mucus or yellow discharge.
Noses: A newborns’ nose is often flat a covered with milia, which are pimple like bumps and represent immature oil glands which will go away without any treatment. It’s very common for an infant’s nose to appear to be stuffy. Hold a mirror directly under each nostril; if mist appears on the mirror, the nostril is open. Try saline drops, one drop in each nostril, as often as needed. The stuffiness disappears, as the nostrils get bigger, usually by 2 to 4 months of age.
Mouth with white spots: Epithelial pearls are found on the gum or hard pallet and are about the size of a pin head will go away by 2 months of age. Thrush consists of white patches on the tongue and inner cheeks. It can be confused with milk or formula (which easily wipes off). Call our office if you think your child may have thrush.
Skin: Many babies get red blotches with a small white lump in the center. They will come and go in the first one to two weeks. These are called erythema toxicum neonatorum and are benign. When first born, the skin of a newborn will be slightly mottled at first and may be covered with a pale cheesy coating called vernix. Fine, downy hair called lanugo will also be present, but it usually disappears within a few weeks.
Acne: Usually begins around 2 weeks of age and may last up to 4 to 6 months. Baby lotion may make it worse. Keep it clean with soap and water.
Dry Skin: Babies loose their outer layer of skin after they are born. You will see flaking especially around hands, feet and ankles and extremities. Remember they have been living in a fluid filled environment for the past 9 months. Avoid using a lot of baby lotion; just let it flake off.
Stork Bites: These are flat pinkish red birthmarks found on the back of the neck or above the nose and eyes. Most of the facial marks will go away by 18 months. 25% of the neck birthmarks will remain, but are covered by hair.
Breast enlargement: May occur in both male and female newborns in the first few month of life and may last 6 to 12 months. It is due to hormones that have been passed on by the mother before birth. Occasionally you may note a drop of milk coming from the enlarged breast, nothing to worry about.
Umbilical cord: Often you will note some yellowish discharge underneath the dry cord. The cord should fall off between 10 and 30 days of age. And as it separates, you may note oozing of blood for some days. This is normal and you should continue cleaning the cord as you were instructed at the hospital. Don’t be afraid to lift up the dry part in order to apply a little rubbing alcohol to the moist part below. Call us immediately if there is any red streaking, swelling or inflammation around the cord.
Genitals: Girls may have a white, sometimes blood tinged, discharge from their vagina in the first 2 weeks (nothing to worry about). 10% of girls will have a moist pink skin tag coming from the vagina. This will resolve in 1 to 2 months.
Boys may have fluid collection in their scrotum, this is called a hydrocele, call us if it seems to change in size.
Circumcision: You may see some yellowish skin on the head of the penis, or at the head of the remaining foreskin, which will return to normal in 10 days and represents part of the healing process. Keep the circumcision clean with water and apply petroleum jelly to the head of the penis to keep it from sticking to the diaper. If there is marked redness or swelling with streaks running towards the body, call our office.
Bowel Movements: Stools may vary in color and consistency, often are mustard yellow with a cottage cheese consistency. During the first few months, many babies may strain when they stool, even when the stool is soft. Don’t worry about this unless your baby’s stool is very hard or has a clay consistency. Call us if your breastfed newborn is stooling less than 3 to 4 times a day in the first few weeks of life.
Finally, don’t worry about hiccups, sneezing, yawning, a little spit up, passing gas, occasionally jittering of the arms and legs when crying or startling to noises brief moro reflex