Newborn Info

Important Reminders:
If you would like your newborn to become a patient with one of our physicians, simply inform your hospital delivery team that you have chosen North Atlanta Pediatrics as your pediatrician.

• Call our office once your baby is born to register with our practice and schedule your baby’s first appointment for 1-2 days after being discharged from the hospital.
• Subsequent newborn appointments may also be scheduled at this time. They include the following ages:
  A newborn check-up at 10-14 days of age
• One-month appointment
• Two-month appointment
• Notify your insurance company about the birth of your child immediately and specify your child’s Primary Care Provider (PCP).
• Use the newborn checklist as a guide for your first visit to the office.
• Go to Patient Info and select Forms from the drop-down list, there you will see several forms. You will need to print and fill out forms for Family Registration, Family History, & HIPAA Privacy. These need to be completed and given to the front desk when you check in for your first appointment.

Checklist for Parents of Newborns
Before you leave the hospital, obtain the following information to bring to the first visit:

• Discharge weight _____________________
• Results of any lab tests performed
• Results of Bilirubin tests, if done
• Results of blood type tests for mom and baby (if done). Keep a record for yourself as well
  The State of Georgia currently requires a hearing screen to be done on all newborns before discharge.
• Please bring the hearing screen report to the first visit

Newborn Metabolic Screening Test – The State of Georgia screens for many metabolic diseases as well as for Sickle Cell Disorders. This test will be done in the hospital before discharge. If it is done before the baby is 24 hours old, it will need to be repeated at their first visit in the office.

• Record date and time test was done ___________________________
  Please call the office and schedule the following appointments:
• Newborn Post D/C Visit at 1-2 days after discharge from the hospital
• Newborn visit at approximately 7-10 days of age with one of our Nurse Practitioners
• Visit # 2 at approximately 1 month of age
• Visit # 3 at approximately 2 months of age
  Call your insurance company and your employer’s human resource department to add your baby to your health insurance policy.
• Record the date the call was made
• Remember to bring the insurance card to every visit
  Complete the forms included with this book to bring to your first visit:
• New Patient Information
• Family History
  A printer-friendly version of this form is available on our Patient Forms page.

Newborn Instructions
Congratulations on the birth of your new baby! This is an exciting and rewarding time for you as new parents to watch your baby grow and develop. As new parents, there are many common problems and questions which may arise. As long as your baby is well-loved, well-fed, warm, and comfortable, they won’t mind if you are less than an expert. Loving your child, common sense, and the ability to adapt to particular situations are the keys to successful child-rearing.

Breast Feeding
We strongly encourage breast feeding; however, the choice of breast or bottle feeding is up to you. Whether you choose breast or bottle feeding, we will support you in maintaining the best possible care for your infant. Even if you are returning to work and cannot breast feed your baby for more than a few weeks, support is available to help you reach your goals. We recommend feeding at both breasts every 2-3 hours for the first 3-5 days to help establish breast milk supply. You may need to wake your baby for daytime feedings. We will make more tailored recommendations for your schedule once we have seen your baby in the office.

Breast Pumps
Breast Pumps are available for expressing and storing milk. Pumps may be manually operated, battery-operated, or electrical (plug-in type). Generally, electrical pumps produce the best pumping action. If you use a pump, buy or rent one that’s designed for easy cleaning.

Bottle Feeding
Infant formula will provide all calories, minerals and vitamins your child will need for normal growth. Water will add fluoride to your infant formula.
Always hold the baby, never prop the bottle in bed or leave the baby unattended while feeding. Initial feeding may be as little as 0.5 to 1 ounce/hour since last feed.

Sterilization
It is not necessary to sterilize bottles or nipples if they are carefully washed and thoroughly rinsed. A dishwasher is quite satisfactory. You do no need to boil city water. If you use well water, it should be boiled.

Schedule
Feeding schedules should remain flexible, allowing the baby to eat when they become hungry. This most commonly occurs every 2 ½ to 4 hours. If your baby sleeps longer than 4 hours between feedings during the day, you may wake your baby to feed.

Vitamins and Fluoride
Babies need supplements of vitamin D if they are over 2 months and breast feeding, or if they are formula-fed and taking less than 17 ounces of prepared formula. We recommend PolyViSol or Carlson’s Vitamin D.
If your child is not receiving any tap water, after 6 months of age, he/she will need a fluoride supplement.

Bowel Movements
Stools of newborn babies vary in size, color, consistency, and frequency. Most normal stools are semi liquid, “seedy,” and yellowish or greenish. Bowel movements may occur as often as with every feeding or as infrequently as every 3 to 5 days. Even though the baby may strain, unless the stool is hard and pellet-like, it is not constipation. It is perfectly normal for a baby to pull his legs up grunting and crying to have a bowel movement. This is her way of pushing the stool along.

Bathing
The sponge bath technique should be used in bathing until the umbilical cord has fallen off and the navel area healed. You may then begin with tub baths. Mild soaps like Cetaphil or Cereve are excellent for bathing infants. Baby shampoos (Aquaphor Baby Hair and Body) are helpful when washing the hair since most will not burn the eyes. You may wash your infant’s face with the shampoo or with soap and water. Most infant bath soaps will not irritate eyes. Soap and water or commercial baby wipes are satisfactory in bathing the diaper area. However, if redness or irritation in the diaper area develops, discontinue the wipes and use paper towels with water instead. You may apply Vaseline as a protectant for the bottom if it looks red. There is no need for soap at each diaper change. Creams, lotions, or oils are not necessary on your infant’s skin unless excessive dryness is present. Hypo-allergenic creams can be used after a bath. Powders may be dangerous if ingested or inhaled and should not be used routinely. Stool may be cleaned from female genitals with water or baby wipes.

Umbilical Cord
The umbilical cord should be cleaned using a cotton swab or cotton ball saturated with alcohol daily until it falls off. Make sure you gently lift the cord, so you can clean around it completely. Some oozing and bleeding from the cord is normal. If the cord becomes moist from bathing or urine, air dry. Report any inflammation, persistent bleeding, or odor.

Circumcision
Keep the circumcision area clean with plain warm water. Until it has completely healed, coat with Vaseline at each diaper change. Continue gauze as long as it has grey/yellow tissue at the incision site. Most babies need Vaseline and gauze for 5-10 days and Vaseline for up to 14 days. Report any redness or excessive swelling.

Diaper Rash
Most babies may develop, at some time, an irritation or redness in the diaper area. When this occurs, change your baby’s diaper as soon as possible after each stool and as often as possible after wetting. After cleaning the diaper area, pat dry and apply Vaseline, A & D ointment, or Desitin. If the diaper rash does not improve in 3-5 days, notify our office.

Vaginal Discharge
A sticky, white vaginal discharge is common in the newborn female infant. There may be some vaginal bleeding noted within the first few days of life due to withdrawal of maternal estrogen. This is a normal occurrence. Likewise, a baby’s breasts may be swollen for a few weeks (even in males), this will resolve in time.

Environment
The temperature of the baby’s room is right if it feels comfortable to an adult. Dress the baby accordingly, as you would yourself. Do not overdress your baby. The best position for sleeping is on the baby’s back. The mattress should be firm and level, and no pillow should be used. Fresh air is fine for a new baby. An infant may go outdoors at any age, but exposing the baby to direct sun rays is not advisable. No smoking in the same room or automobile with your baby.

Safety
Your baby should always ride in an approved car seat that has been properly installed in the back seat. Infants up to twelve months and/or 20 pounds should be in an infant or convertible seat facing the rear of the car. Children 12 months to 4 years and/or 40 pounds should be in a convertible seat. Keep children in a toddler seat for as long as they fit. For more detailed information on car seat safety, please consult http://safekidsgeorgia.org/carseats/

Fever
When your newborn has a fever, you should call our office if:

• An infant under 2 months of age has a rectal temperature of or over 100.4 degrees F (38 degrees C) or under 97 degrees F (36.5 degrees C).

Taking Your Child’s Temperature
We recommend taking rectal temperatures in infants. A normal range when taking your baby’s temperature rectally is 97 degrees F (36 degrees C) to 100.3 degrees F (37.9 degrees C). Below are a few helpful tips to guide you in that process.

1. Lubricate silver bulb end of a rectal thermometer with K-Y jelly or Vaseline.
2. Lay infant flat on his or her stomach and spread buttocks so anus (lower opening of the digestive tract) is easily seen.
3. Hold thermometer between thumb and index finger so that your palm can rest on the buttocks. Slowly and gently insert thermometer 2 centimeters (slightly less than an inch or about the length of the end of a pinky finger)) into the anus. The silver tip will no longer be seen.
4. Hold thermometer carefully in place for 1 – 2 minutes (most digital thermometers will beep when complete). Hold infant still with other hand.
5. Remove thermometer.
6. Read degree of temperature.

IMMUNIZATION SCHEDULES
Your baby will require certain immunizations for protection against childhood diseases. North Atlanta Pediatric Associates is committed to immunizing all infants with all vaccines required by the state of Georgia, We do not recommend or accommodate alternative vaccine schedules.

CHECKUP SCHEDULE
These are the ages at which we typically do checkups. Contact the office as soon as possible after the birth of your child to schedule your newborn, one-month, and two-month checkups. We open our schedules six months in advance so please call in advance to schedule routine physicals. We recommend annual checkups on all children three years and older.

Newborn         1 month           2 months         4 months         6 months         9 months
12 months       15 months       18 months       24 months       30 months
Annual checkups for ages 3 years and up

HELPFUL READING
What to Expect the First Year by Arlene Eisenberg
Infants and Mothers by Dr. T. Berry Brazelton
Moms on Call: Basic Baby and Toddler Care by Jennifer Walker, RN and Laura Hunter, LPN
The Happiest Baby on the Block by Dr. Harvey Karp
The First Twelve Months of Life by Frank Caplan
Womanly Art of Breast-Feeding by La Leche League
Caring for Your Baby and Young Child by Steven P. Shelov, M.D.
Caring for Your Baby and Young Child: Birth to Age 5 American Academy of Pediatrics
Solve Your Child’s Sleep Problems by Richard Ferber
Healthy Sleep Habits, Happy Child by Marc Weissbluth