Breast Feeding

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Congratulations on the birth of your baby!  Now you can relax, and enjoy the new addition to your family.

Suggestions for nursing:

I recommend that you feed whenever the baby is hungry.  Teach your baby that you trust his appetite!  Your baby should nurse at least 8 to 12 times in a 24 hour period.  Some of these feedings may be clustered very close together, even 1-2 hours.  During the day, don’t let the baby nap for longer than 2 ½ hours between feeds; wake the baby for feeds if needed.  But you can let the baby sleep at night, while you are asleep.  The baby does not need water.  Cereal and solid food is not generally started until 4-6 months of age.

Many babies do not need a pacifier; if your baby wants a pacifier, you should offer it only if you have just fed the baby within the last 10-15 minutes so that you know he is not hungry.

When your baby is 2 weeks old, begin ADC vitamins, 1 dropper-full per day ("Tri-vi-sol" or other brand, no prescription needed, “with iron” if possible).  Be sure to take care of yourself as well! Continue your prenatal vitamins and iron (perhaps as long as you might be bearing more children).  Get as much rest as possible, eat a well balanced diet, and drink plenty of fluids.

When storing breastmilk for later use, be sure all equipment is sterile. Breastmilk can be stored 48 hours in the refrigerator, or 4 to 6 months in the back of your freezer (not on the door).

If you ever plan to give your baby a bottle, you will have the most success if you introduce a bottle (with expressed breast milk or formula) once or twice a day, beginning between 3 to 4 weeks of age.  This age is late enough that the breast milk will be well established, but young enough that your baby can still become used to a rubber nipple.

Routine infant care:

Keep babies sleeping on their back.  Babies ride in a car facing backwards, in an approved car seat  in the rear seat,  until they reach 20 pounds and they are a year old.

To care for the umbilical cord, a little soap and water, or hydrogen peroxide, is adequate.  (Be sure to pull the skin away from the cord as you clean, so that an infection doesn’t develop at the base of the cord.)  If the skin seems dry, any lotion is fine to use if it has no perfumes or dyes.  You may bathe the baby in any manner that seems sensible to you.

Excessive exposure to television has been shown to be harmful for your baby’s development.  I recommend that the TV not be allowed to play in the baby’s earshot for more than 1 hour per day.  However, music (whatever you enjoy) is beneficial as a nice social stimulation, and you may play music as much as you like.

Smoke is very irritating to your baby! It puts the baby at risk for pneumonia and ear infections.  Never let anyone smoke in your house; ask them to go out to the balcony or back porch. Don't smoke in the car.

Keep the house at a comfortable temperature for you.  Dress the baby as you dress yourself.  Fans and air conditioning are ok, if not aimed directly at the baby. Furnish the room simply; carpeting, upholstery, stuffed toys and drapes collect dust which may irritate the baby's nose.  You may take the baby outdoors as soon as you arrive home, if the weather is nice. You may have visitors or take the baby to the home of family or friends if the number of people is limited and no one has a contagious illness.  Do not expose the baby to a large family gathering or take the baby shopping or to church for the first 6-8 weeks.

If your baby has a stuffy nose, you may make saline drops (a pinch of salt to 4 oz. water) to drop into the nostrils.  A cool humidifier with plain water is also helpful; change water daily and dry between uses.  For the first 8 weeks, it the temperature is over 100.5, call us immediately.

Our office:

We are available for emergencies by phone 24 hours a day. If your baby becomes sick outside of regular hours, and you feel that the baby needs help before office opens, dial 392-2077 and leave a message.  I, or the covering pediatrician, will return your call very quickly.  Please limit after-hours calls to urgent problems that cannot wait for the next day.  I prefer that you avoid the Emergency Room if possible.

For routine advice and questions, I am happy to help you any weekday morning. Please don't hesitate to ask our advice; I expect new parents to have many questions!  If the nurse can help you, she will. Occasionally she will suggest that you leave a message for me, or that you come in for a sick visit.  The first visit to the office should be 2-4 days after discharge from the hospital.

Remember:  The most important influences on your baby’s long term development come from the baby’s social environment.  Teach your baby that you trust him, by trusting yourselves.  You can’t do it wrong … so have fun, and enjoy your family and your baby!

Copyright © 2007, David Epstein MD