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Pediatrics

Welcome to The Iowa Clinic Pediatrics Department. Our doctors provide a full range of pediatric services for patients from birth through adolescence.

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Newborn & Infant Care Guide for New Parents

From feeding time to bedtime, find the answers you need to confidently care for your baby. Read through the whole new parent guide or jump ahead to the topic where you have the most pressing questions:

  • Feeding Tips
  • Newborn Noises: Gas, Hiccups & Sneezing
  • Diaper Duty
  • Illnesses & Caring for a Sick Baby
  • All About Immunizations
  • Sleep Advice

Feeding Your Baby

How much should a newborn eat?

It takes time to get to know your baby and understand when they’re ready to eat. Watch for their cries and cues (like suckling) to know when they’re hungry. 

Most newborn babies feed on demand. At a minimum, you should feed your newborn every 2–3 hours during the day. At night, you should feed your baby every 4 hours — even if it means waking them up — until they are back to birth weight. Once your baby is back to their birth weight and gaining weight well, you can allow them to sleep as long as they want between nighttime feedings.

How do I know my baby is getting enough to eat?

Every baby is different and so are their eating habits. There are a few ways to know that your newborn is getting enough to eat:

  1. Count wet diapers. Wet diapers mean your baby is well-hydrated. As a rule of thumb, a newborn should have 1 wet diaper per day of life, until they are 6 days old. After that, your baby should have at least 6 wet diapers per day.

  2. Watch their weight. Paying attention to weight gain is also helpful. Most babies should be back to their birth weight by 2 weeks. In the first few months, babies should gain 1⁄2 to 1 ounce per day.

  3. Monitor their behavior. Healthy babies are happy babies. If your child is happy in between feedings, it’s a good sign that their belly is full and they are content.

Can I overfeed a breastfed baby?

No. In fact, it is normal and healthy for your baby to want to feed frequently — even every hour! This can be overwhelming for a new mother, so read up on the breastfeeding basics for tips and tricks for nursing your newborn. 

When should I introduce a bottle?

In general, you can introduce a bottle as soon as breastfeeding is well-established. Typically, this happens by 4–6 weeks of age. 

When can my baby eat solid foods?

Wait until your baby is 4–6 months of age before introducing solids. They should only have breastmilk or formula until then.

Do pacifiers cause nipple confusion?

No! Recent studies have shown that pacifiers do not cause nipple confusion. You may introduce a pacifier right away as long as breastfeeding is going well. If problems with breastfeeding develop, consider taking the pacifier away until these problems are resolved.

Newborn Noises

My baby seems gassy or uncomfortable with bowel movements. What can I do?

It’s common for babies to seem uncomfortable when passing gas or stool, as their digestive system is still immature. It takes some time for babies to learn to coordinate their musculature to toot and poop. 

Often, babies cry in order to increase intra-abdominal pressure and subsequently pass gas or stool. There’s no good evidence that gas drops or gripe water are effective, though some parents find these treatments helpful. 

In general, this is just one of the many phases your baby will go through. With time, they will overcome their discomfort and happily toot or poop.

How often do babies hiccup?

It can feel like your baby hiccups all the time. This is common and quite normal. It’s actually due to their developing nervous system. 

So don’t worry — you’re doing nothing wrong! And there is likely nothing you can do to make the hiccups stop. This is another thing that gets better with age and eventually goes away on its own.

My baby sneezes all the time. Do you think they have allergies or a cold?

Like hiccups, sneezing is very common in newborns. During the first few months of life, babies prefer to breathe out of their noses. Sneezing helps babies to clear out their nose to breathe better.

Allergies typically do not develop until a child is 2–3 years old. And, unless the sneezing is accompanied by a runny nose or cough, it’s unlikely your baby has a cold. If you do see cold symptoms in your child, talk to your pediatrician to see if there’s anything you can do or if you need to schedule a sick visit.

Diaper Duty

My baby isn’t pooping. Is she constipated?

Unless the stools are hard and pebble-like, it is unlikely that your baby is constipated. So look at the consistency of the stool more so than the frequency. 

Babies have different bowel habits. Some breastfed babies poop several times a day. Others, only once a week. The frequency often changes from the first month to the second. If your baby is eating well and gaining weight, there is no need to worry about how often they poop.

What color should my newborn’s stool be?

It comes in all colors of the rainbow! With the exception of red, black or white, any color is normal.

Why is there blood in my baby girl’s diaper?

Don’t be alarmed! A small amount of bloody vaginal discharge is relatively common. It’s due to the withdrawal of maternal hormones. After the first few weeks, this issue goes away and you shouldn’t see any more blood in the diaper. 

Newborn Sleep

How should I put my baby to sleep?

Remember, back is best. Always place your baby on their back to go to sleep. It’s also important that they sleep in their own space — whether that’s a crib or bassinet. Both of these are critical for the safety of your newborn.

What’s a good bedtime for a newborn?

During the first few weeks, bedtime is usually later than you’d think — as late as 9pm. Around 6–8 weeks, start moving your baby’s bedtime earlier to somewhere between 6 and 8pm.

What should my baby wear to sleep?

A cool, comfortable temperature creates a safe and healthy sleep environment. Keep the temp in your baby’s room between 68 and 72℉ at night. 

Dress them appropriately for that cool, nighttime temperature. Follow the one extra layer rule. If you are comfortable in a t-shirt, put your baby in a onesie and one extra layer of clothing like a swaddle or sleep sack to keep them warm and snug.

Should you ever wake a sleeping baby?

Sometimes! During the first couple of weeks, you should wake your newborn if it’s been 3 hours since they last ate. It’s also helpful to wake your baby throughout the day to eat, in order to facilitate better sleep at night. A well-fed baby sleeps better!

How can I help my baby sleep?

In the early weeks, your baby needs help learning to sleep on their own. It’s completely okay to help soothe your baby to sleep, and natural for them to prefer being held for sleep.

Swaddle, rock, bounce, swing, nurse, offer a pacifier — all are helpful in getting your baby to sleep. None will spoil your baby or establish poor sleep habits! 

You can also try these other tips to help your newborn sleep:

  • Try putting your baby down to sleep for a nap in their crib at least once during the day.
  • Offer playtime and sunlight during the day and keep nighttime quiet, dark and calm to avoid day-night confusion (which is common in the early stages).
  • Use a sound machine to soothe your baby and drown out other noise.
  • Follow a consistent bedtime routine.
  • Hold off on sleep training or crying it out until your baby is 4–6 months old. These methods are ineffective before then.

What can I do to prevent SIDS?

SIDS, or sudden infant death syndrome, is the unexplained death of a seemingly healthy baby. And it often occurs during sleep for babies less than a year old. There is a lot you can do to create a safe sleep environment and prevent SIDS:

  • Place your baby on their back to sleep.
  • Put your baby on a firm, flat surface in a crib or bassinet every night and for every nap. Do not let your baby sleep in Rock ‘n Plays, swings, car seats, wedges, sleep positioners or bouncers. All of these increase the risk of upper airway obstruction and oxygen desaturation.
  • Keep the crib free of loose blankets, pillows, toys or anything else that could obstruct breathing.
  • Sleep in the same room (but in different sleep spaces) in the first 6 months.
  • Maintain a room temperature between 68 and 72 degrees Fahrenheit.
  • Follow the one extra layer rule and avoid overheating your baby under too many blankets or clothes.
  • Turn on a fan.
  • Offer a pacifier.
  • Give your baby plenty of tummy time during the day so they build the strength to lift their head and push away from potential obstructions.
  • Refrain from smoking in your home.

Newborn Illnesses & Sick Care

When should I take my baby’s temperature — and how do I do it?

Any time you think your baby may be sick! Fevers are a sign that the body is fighting an infection. There are a variety of reasons to check your baby’s temperature that may also signal sickness, like increased fussiness, feeling warm, cough or runny nose.

There are a variety of thermometers out there. We recommend using an under-the-arm or rectal thermometer to check your baby’s temp. Rectal temperatures are most accurate, but readings can vary across devices. Never add or subtract degrees from the temperature reading. Just tell your pediatrician what it says and how you took it. 

What is a fever for a baby?

No matter which way you take a temp, 100.4 degrees or higher is a fever. A fever in a baby under 2 months of age is an emergency and you should contact our office immediately.

Can I give my baby Tylenol?

When your baby is ill or spikes a fever, you can give them fever reducers like Tylenol (acetaminophen) or (Motrin) ibuprofen — once they reach a certain age. Acetaminophen is safe for babies 12 weeks and older. However, you should not give a baby ibuprofen until they are 6 months old. 

Always check the dosage chart for Tylenol or Motrin products, as different formulas have specific dosage and age recommendations.

Newborn & Infant Immunizations

When does my baby get vaccines?

The immunization schedule for children starts at birth. At subsequent well child visits, your baby gets additional immunizations based on American Academy of Pediatrics (AAP) guidelines. In the first year that schedule includes recommended vaccinations at 2, 4, 6 and 12 months.

Can I give my baby Tylenol before the vaccines?

No. Studies actually show that giving Tylenol before vaccines can diminish the immune response and overall effectiveness of the vaccine. You may administer Tylenol afterward though. Fevers and fussiness are common following immunizations, so a dose of acetaminophen may be just the thing your baby needs.

Do I need vaccines as a new parent?

Yes! Parents, grandparents and anyone else who will have frequent contact with your baby need to be vaccinated to help prevent diseases from spreading to your newborn. The AAP highly recommends that you get these two immunizations:

  • Flu shots (yearly) to fight seasonal influenza
  • Tdap vaccines help to prevent whooping cough. Studies show that immunity can wane as quickly as 2–5 years after receiving the vaccine, so you may even need a booster between children.

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