Serving Lawrence Families for Over 30 Years

Pediatric And Adolescent Medicine, P.A.

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G. Charles Loveland, MD Marshall D. Kelley, MD terrance P. Riordan, MD Anne VanGarsse, MD Beth Rundquist, MD Chris Koster, MD

congratulations!

We are excited to welcome your newborn and look forward to being involved in his or her care. This booklet contains information addressing many common questions and concerns. We hope it can serve as easy reference in the coming days and weeks.

Breast feeding

. The first 4-5 days are practice for mother and baby . It is normal for newborns to lose weight at first. . Uncomfortable engorgement may occur in the first 2-3 days. It may be relieved with warm compresses, Tylenol, or expression with the hand or breast pump. . Mother should drink extra fluids; she should stay rested and should try to reduce stress. . Feed the baby every 2-3 hours for the first two weeks. . In later weeks, if the baby is fussy less than three hours after a feeding, attempt to sooth first before feeding. . Electric pumps are best for pumping. Breast milk can be refrigerated 5-8 days, frozen 3-6 months. NEVER heat milk in a microwave; reheat by rinsing the container under warm water. Bottle feeding

. Mix formula according to the directions on the label. . Discard what is left of a single serving of mixed formula. Bulk amounts of formula made from concentrate or open containers of ready-made formula can be refrigerated up to 48 hours. . Sterilization of bottles is unnecessary; wash in hot soapy water or the dishwasher.

Baby is eating enough when:

. He or she is content for 2-4 hours after a feeding. . He or she has 6-8 wet diapers a day. . After the first 1-2 weeks, the baby gains ½-1 ounce per day. . Do not give the baby any cereals or solid foods until 4 months.

Stools and diapering

. Pay attention to changes in baby’s stool. Call if pellet- like, watery (yellow, watery, seedy stools are normal if breastfed) or bloody. . If breastfed, a baby can have multiple stools a day or as few as one every two weeks. They are normal if they are soft. . Fine, red sensitivity rashes can be prevented by avoiding perfumed diapers and wipes, especially in the first six weeks . Try barrier creams and ointments like Vaseline, A&D Ointment, Aquaphor or Desitin on slight rashes . Rashes that don’t get better with the above treatments should be seen by a doctor . Circumcision: o Gomco clamp: Clean with warm washcloth if soiled, Vaseline for 2 days, less swelling expected in 2-3 days, apply pressure for 5 minutes for active bleeding, call if bleeding recurs o Plastibell: Warm washcloth if soiled, ring usually drops off in 7-10 days, Vaseline only if penis sticks to the diaper, some swelling and redness expected just before ring comes off. . Vaginal Care: o Clean with plain water, front to back o Whitish or blood-tinged discharge is normal during the first few weeks

Cord care

. Sponge baths only until the cord stump site has healed. . Likewise, sponge bathes until the circumcision site has healed. . Move the cord stump around gently to expose to air; rubbing alcohol is not necessary . Allow up to 6 weeks for the stump to break away . Expect some oozing of blood . Call the office if: o Cord develops a foul odor o Cord becomes more moist rather than drying o Skin around the cord becomes reddened

Bringing baby home

. Laundry: Use a scent-free, color-free detergent. Do not use fabric softeners or any additional chemical treatments. . Outdoors: You may take the baby out in nice weather. Avoid crowds the first two months of life. Protect from sunburn by shading the baby and be mindful of surfaces that are reflecting sunlight. Cover baby’s face in extreme cold. Avoid wind. . Car Seats: Put baby in a rear facing car seat. The American Academy of Pediatrics recommends that children remain rear facing until two years of age. Use our website links to review current laws and guidelines. . Sibling Response: Expect some behavioral changes in siblings with baby’s arrival. It is normal for your older child to show some regressive behaviors like wetting pants, thumb sucking, and baby talk. o Set aside special one-on-one time with the older child each day o Keep rules and routines intact o Include the older child in the infant’s care o Make frequent, brief physical contact with the older sibling . Clothing: Make the room temperature comfortable for an adult and then dress the baby in one more layer than you. If the baby is too cold, he or she will cry. If too hot, the baby will sweat and might get a heat rash.

Bathing

. Never leave your child unattended in water or on an elevated surface! . Set hot water heater to less than 1200 F . Warm bath water such that it feels warm, but not hot, on your inner wrist (99-1000) . Babies do not need a bath every day. . Use only baby soaps or Dove on both skin and scalp . No soap on baby’s face . Brushing hair with a soft brush daily helps prevent cradle cap . Clip nails straight across and not too short . Do not use Q-Tips as they may cause internal damage to ears and nose. . Use lotions for dry skin; avoid oils

Normal newborn conditions:

. Hiccups and sneezing . Breast enlargement in the baby because of mother’s hormones . Watering and mattering of the eyes; usually a blocked tear duct. . Curving of the baby’s legs; cause by being in the womb, will usually straighten after several months of walking. . Tiny white pimples during the first week of life. . Pink patches on eyelids, forehead, nose and the nape of the neck. Sometimes called stork bites or angel kisses; usually gone by two years of age. . Broken blood vessels in baby’s eye(s) until 2-3 weeks old. . Mild yellow tinge called jaundice. Only be concerned if the baby is not eating well, is lethargic, is very fussy or if the baby is becoming noticeably more yellow.

Signs of illness in newborns

. Rectal temperature above 101. Only check temperature if the baby feels warm or acts sick. . Low urine output (less than 3-4 diapers per day) . Blood in stools. . Irritability: Inconsolable for more than 30 minutes . Refusal of feedings (more than two feedings in a row) . Explosive diarrhea stools and forceful vomiting sIDS . SIDS is the sudden, unexplained, unexpected death of an infant in the first year of life. . To help prevent SIDS, babies should be put on their back to sleep. They should sleep alone in their own crib with no blankets, toys, pillows, bumpers, etc. inside of the crib. . Smoking by the mother during pregnancy, and secondhand smoke exposure after birth, both increase the risk for SIDS.

Postpartum depression

. Emotion due to hormonal changes and fatigue is quite normal and should improve with time and rest. . If you feel like you can’t cope or have thoughts of harming yourself or your baby, call someone for immediate support and then call your doctor.

Office visits

. Well checks are extremely important and should not be skipped. . At check-ups, you will receive information about your infant’s well being, growth and development.

Online services

Many online services are available through our website and Patient Portal. You can pay bills, view medical records, request refills, and send messages to staff. There are links to trusted resources, symptom-specific information, useful paperwork, and our Facebook page. www.pandapeds.com

Infant visits and Immunizations

Age Appointment Vaccine(s) Birth Seen in Hospital Hepatitis B 3-4 days Newborn Checkup 1-2 weeks Newborn Follow-up 4-6 weeks 1 mo Checkup DTaP, IPV, Hepatitis 8-12 weeks 2 mo Checkup B, Hib, Prevnar, Rotavirus DTaP, IPV, Hepatitis 4 months Well Checkup B, Hib, Prevnar, Rotavirus DTaP, IPV, Hepatitis 6 months Well Checkup B, Prevnar 9 months Well Checkup MMR, Varicella, 12 months Well Checkup Prevnar, Hepatitis A

Contact us

Mailing Address: Pediatric and Adolescent Medicine, PA 346 Maine St Lawrence, KS 66044

Phone Number: 785-842-4477

Call Doctor available 24-7. In the event of an emergency, call 911. Primary Location Satellite Office 346 Maine St 4824 Quail Crest Pl

At Pediatric and Adolescent Medicine, we strive to provide, in a timely manner, the highest possible quality of medical care and service for our patients and their families.