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Newborn Visit

Congratulations and welcome to this amazing journey. We are honored that you have chosen Premier Pediatrics. At this visit, we will review your baby's birth experience, conduct a thorough newborn exam, and make sure you are prepared for your first month of parenthood.

When should I call Premier?

There is a physician available for an emergency at all times. If any of the following occurs, please call immediately:

  • rectal temperature over 100.4 Fahrenheit or 38.0 Celsius
  • inconsolable or irritability that you cannot resolve
  • inability to awaken for a feed or a weak suck after four hours
  • less than 3 stools or 3 voids over a 24-hour period
  • spit-up/vomiting with a green color
  • yellow color on the torso beyond the umbilical cord
  • bluish discoloration to the torso or lips

If you have a less urgent call, please wait until the office is open at 9 am on weekdays before calling. If you have a question about acetaminophen (Tylenol) or ibuprofen (Motrin/Advil) dosing, please refer to our dosing chart located in the menu bar on the website.

How often should my newborn feed?

Breastfed newborns should feed on-demand. Typically, they will nurse approximately 8 to 12 times a day. Formula fed infants usually take 2 to 3 ounces every 3 to 4 hours.

Can I eat fish if I am breastfeeding?

There are restrictions for breastfeeding mothers and children through six years of age. This is due to elevated levels of mercury content of some larger fish and concerns over the effect of mercury on brain development. The FDA has created three recommendations to help nursing mothers and children limit mercury consumption while still obtaining the health benefits (i.e. omega-3 fatty acids) associated with seafood.

  1. Do not eat Shark, Swordfish, King Mackerel, or Tilefish because they contain high levels of mercury.
  2. Eat up to 12 ounces (2 average meals) a week of a variety of fish and shellfish that are lower in mercury. Five of the most commonly eaten fish that are low in mercury are shrimp, canned light tuna, salmon, pollock, and catfish. Another commonly eaten fish, albacore (“white”) tuna has more mercury than canned light tuna. So, when choosing your two meals of fish and shellfish, you may eat up to 6 ounces (one average meal) of albacore tuna per week.
  3. Check local advisories about the safety of fish caught by family and friends in your local lakes, rivers, and coastal areas. If no advice is available, eat up to 6 ounces (one average meal) per week of fish you catch from local waters, but don’t consume any other fish during that week.

Follow these same recommendations when feeding fish and shellfish to your young child, but serve smaller portions (2-4 ounces). For more detailed information, Please consult the NYC handout “5 ways to limit mercury.”

Should my baby take vitamin D supplementation?

The AAP recommends that all infants have a minimum daily intake of 400 IU of vitamin D beginning soon after birth. Exclusively and partially breastfed babies should receive 400 IU of vitamin D each day starting in the first few days of life and continuing up until babies are weaned to at least 32 ounces of vitamin D fortified formula or cow’s milk per day. Any supplement that contains 400 IU is acceptable. Carlson’s is one popular vitamin D supplement because it is all natural and one drop placed on the nipple will give a full day’s supply of vitamin D. D-visol, 1 dropper per day, is a popular supplement as well.

How should I take care of the umbilical cord?

The umbilical cord typically falls off from 1–3 weeks. If you wish to clean the umbilical cord, please use alcohol wipes rather than water.

How should my baby sleep?

Ideally, your baby will sleep on his back with his head turned to the side on a hard cushion with no pillows or stuffed animals in the bed. We do not recommend the use of bumpers.

How should I wash my baby?

Until the cord falls off, you should give your newborn a sponge bath every three days. Wash with water only and keep the umbilical cord dry. If you wish to clean the cord, use alcohol two times a day.

When is it safe to go outside?

When you feel comfortable attending to your baby while juggling all of the accompanying baby stuff (stroller, bottle, clothing), personal interactions, and public distractions that come with a trip outside, you are ready to venture outside. A good rule of thumb would be two weeks or after the umbilical cord falls off. Regardless of when you decide to make this trip, always keep three rules in mind:

  1. Do not allow strangers, especially children, to get too close to your newborn’s face or touch his/her hands.
  2. Always try to time your trips for the mildest portions of the day.
  3. Bring extra breast milk or formula.
What is the appropriate car seat for my baby?

Your infant should be in a rear facing car seat until 2 years of age. For more information on car seats please consult “Car Safety Seats and Transportation Safety”

My baby hiccups, and sneezes, is this alright?

These are completely normal newborn behaviors. Do not be alarmed. If your infant hiccups after feeds, consider feeding a little slower and burping with greater frequency.

What if I feel like I am experiencing a postpartum depression?

Please do not hesitate to call Premier or your Obstetrician if you experience any of the following symptoms:

  • Loss of appetite
  • Insomnia
  • Intense irritability and anger
  • Overwhelming fatigue
  • Loss of interest in sex
  • Lack of joy in life
  • Feelings of shame, guilt or inadequacy
  • Severe mood swing
  • Difficulty bonding with the baby
  • Withdrawal from family and friends
  • Thoughts of harming yourself or your baby

Postpartum depression is a serious but treatable medical condition but if left untreated, it can last for a year or more.

What vaccines and/or screening tests should I expect at this visit?

At this visit your child will receive the Hepatitis B vaccine.