New Parents

If you are the parent (or about to be the parent) of a newborn, CONGRATULATIONS! We look forward to meeting you and your family. Don’t worry! There is nothing that you have to do regarding contacting our office before the delivery except it is always a good idea to verify that we accept your insurance plan. (please call if you are unsure). We will meet you and your baby(s) at Stamford Hospital usually the morning after you have given birth. If you have identified us as your pediatric practice, the hospital will contact us right after the delivery to let us know you are there. However, please let us know beforehand if there are any special concerns, questions, or medical problems that you may have. If we are aware of these in advance, we can discuss the issues and perhaps prepare you for some of the things to expect. It would be helpful if you downloaded and completed the forms below before your first visit to the office (or if you would like we would be happy to take these completed forms from you in the hospital).

This is an incredibly exciting, exhilarating, and maybe daunting time for the whole family. We are here to help. We can help to guide you through the increasingly confusing flood of information and misinformation about childcare that is available. Hopefully, we can also put it all in perspective and allow you to enjoy being a parent without getting overwhelmed.

Addition of New Baby to Your Insurance Plan

It is extremely important that your baby be added to your insurance policy as soon as he or she is born, and that one of our physicians is chosen as the baby’s primary care physician (PCP) if a PCP is required. We accept most commercial insurance plans. For more information see our Insurance Information.

The first year of life can be expensive because of recommended well-care visits and immunizations, so it is important that you understand your insurance benefits. Unfortunately, not all insurance plans cover all well care and immunization costs. Many people are utilizing high deductible plans as well, which means you may be responsible for large amounts (if not all) of the baby’s well care. For patients whose insurance does not cover vaccines, the State of CT provides opportunities in the community to receive vaccines at a lower cost. Connecticut’s VFC (Vaccines for Children) program provides required vaccines for free or for reduced fees. Please speak to one of us if you have questions about this program. If you have any questions regarding your insurance coverage please contact your health care plan.

Some things we think you should know

What to Expect in the Hospital

In the hospital, one of the pediatricians from the Pediatric Center will come to visit your newborn every day during your stay. The first newborn exam will be a very thorough physical examination and we will certainly bring up and discuss any concerns that we may have. This is the time for you to bring up whatever concerns that you may have as well. Subsequent examinations will focus on feeding, jaundice, evidence of infection, and the cardio-respiratory status.

Additionally, while in the hospital your child will have several tests: a hearing screening, the state-mandated newborn metabolic screen, an initial blood sugar/blood count and possibly a blood test for jaundice. Each infant is also going to receive eye ointment to prevent certain infections and will get a Vitamin K shot to prevent a bleeding disorder. The Hepatitis B vaccination will also be offered. (We recommend it!)

Traditionally infants are discharged to home at approximately 48 hours of life. If your child is healthy, full term, and without risk factors for infection; he or she will likely be discharged home between 24-48 hours of life. After a C-section, the infant will stay in the hospital until mom is ready for discharge (3-5 days usually). On the day of discharge the pediatrician will let you know when you need to be seen for follow up. Routinely your first appointment will be between 2-4 days of life as recommended by the American Academy of Pediatrics. After you have been discharged, please call our office for an appointment.

If you are having a baby at a hospital other than Stamford Hospital, we will not be able to care for your infant at the hospital. We would be happy to start seeing you once you have been discharged. We recommend that you call our office when you are discharged so that we may schedule an appointment for your first visit at an appropriate time. (usually 2-4 days after discharge but often sooner if there are particular concerns such as weight loss or jaundice)

First Newborn Office Visit

The first office visit for your baby is usually 2 to 4 days after discharge from the hospital unless you are told otherwise. Please call our office to schedule this appointment as soon as possible after discharge. If your baby was not born at Stamford Hospital, please bring any information about the baby that you are given from the “delivering” hospital. At this visit the baby’s weight will be checked, a physical exam will be performed, and we will answer any questions you may have.

Following this initial visit, we will see your baby regularly until feeding and weight gain are established and again at 2 weeks of age.

Well Baby Visits

Regular well care and immunizations are key to keeping your baby healthy, monitoring development and preventing illness. Please call our office to schedule well-child care visits at the ages shown below (* indicates routine immunizations as of 1-2011). Appointments for well care may be made up to six months in advance, so appointments for your baby’s next well care can easily be made while you are in our office for a current visit.

1st visit 1 month* 4 months* 9 months* 15 months* 2 years*
2 weeks 2 months* 6 months* 12 months* 18 months*

Lactation Counseling

The providers at The Pediatric Center believe that breastfeeding is the healthiest way to feed your baby, and we are dedicated to helping you and your new little one establish successful breastfeeding. Our providers can all give you information and support on breastfeeding, as well as some helpful tips to get you started. If you need additional assistance, our providers may refer you to Courtney Parker, our certified lactation counselor and APRN. If you have questions regarding breastfeeding, or need assistance please consider one of the following resources:

  • Our doctors, nurses, and nurse practitioners are available to provide advice during regular office hours. They can help you or help you decide if you need to be seen at the office or need the services of a lactation consultant.
  • Courtney Parker, APRN, IBCLC (the certified lactation consultant at TPC)
  • Use the services of the lactation consultant that you met at the hospital.
  • Get a referral to a community-based lactation consultant from our office.
  • Read some of the material that is on our website (see below) or material that is linked to from our website…..but don’t go crazy!

Breast Feeding

We encourage breastfeeding as the most natural, satisfying and beneficial way to feed babies. In addition to maintaining a close mother-baby relationship, breastfeeding offers benefits to both mother and infant. Moms experience quicker postpartum recovery, reduced health risks, and psychological benefits.
Breastfeeding provides your baby with the ideal milk, enhanced immunity (protection from disease), and a lesser incidence of allergies. Studies also show psychological, developmental and cognitive benefits for breastfed babies. In addition, breastfeeding is less expensive and often more convenient.

The best rule for breastfeeding is to nurse as frequently as your baby seems interested. We feel that babies often do best on their own schedule. As you feel up to it, nursing about every 1 to 3 hours the first 2 to 3 days brings your milk in more quickly and minimizes the breast engorgement that may accompany the arrival of your milk supply. Most babies feed 10 – 20 minutes per breast, typically longer on the first breast. You will know the infant is done when he or she either “pops off” the breast and doesn’t immediately root again or falls asleep with the breast in his or her mouth. Though a baby will typically nurse from both breasts, he or she may occasionally be satisfied after nursing on just one side. After nursing on the first breast, burp the baby, try to reawaken and offer the second breast. When feeding your infant, watch the baby, not the clock. You should see intermittent swallowing and a gentle ear wiggle with nutritive suckling. Begin each new feeding on the breast that was nursed from last or not used at all in the previous feeding. To ensure successful breastfeeding first awaken your baby by fully unwrapping him or her, changing the diaper or briskly rubbing his or her body or feet. Next, if your baby is not already rooting, stimulate the sucking reflex by letting him or her suck on your finger or by stroking the cheeks. If you need to, stimulate your nipple to get it erect. When latching the baby you need to assist the infant with head control; this is easily achieved in the football position. To achieve a good latch, the baby’s mouth should be open wide and draw in an inch and a half of breast tissue into his or her mouth.

Nipple tenderness is frequently experienced in the first week of breastfeeding with the initiation of each feeding. Pain that persists the entire feeding is not normal. The very best way to prevent nipple soreness is by making sure the baby is properly positioned on the breast. When properly positioned, the baby’s jaws go beyond the nipple to come together on the areola, about an inch and a half in, not on the nipple itself. Babies who take enough of the areola into their mouths massage the breast which causes milk to be released from the ducts. Babies who suck or chew only on the tip of the nipple do not empty the breast effectively and cause sore nipples. You can soothe soreness by expressing breast milk onto your nipples and exposing them to air dry after each nursing. You may also try lubricating sore nipples with lanolin (available at the pharmacy or grocery store) after each nursing. You need only clean your breasts once a day when bathing with warm water. Once you are home from the hospital it is best not to let your baby go more than 2 to 3 hours between daytime feedings. However, once your milk is in you may let him or her sleep one five hour stretch at night. Encouraging your baby to nurse more often during the day may result in the baby sleeping a little longer at night.

After the first few days of nursing, there are signs from both mother and baby that indicate breastfeeding is going well.

For mother these include:

  • milk “comes in” about 2 to 5 days after delivery
  • nipple tenderness gradually decreases
  • breasts feel full before nursing and become softer after feeding
  • a “let-down” or tingly, pins and needles sensation including milk dripping and spraying (more typical after 2 to 3 weeks)

For baby these include:

  • nursing 8 to 12 times in 24 hours (about every 2 to 3 hours) with at most one 5-hour stretch at night
  • seeing/hearing swallowing during nursing
  • baby is relaxed and falls asleep after nursing
  • bowel movements that look like yellow, seedy cottage cheese or mustard by the 4th or 5th day of life, and come either after every feeding or every other (frequency will decrease with time)
  • wet diapers 6 to 8 times a day with pale yellow, odorless urine

It is important that a breastfeeding mother eat regular, balanced meals. You will need about 500 extra calories per day above your normal pre-pregnancy diet and should remain on your prenatal vitamins while nursing. You may eat any food that agrees with you, even spicy foods. Avoid excessive amounts of caffeine and alcohol, but an occasional glass of either is all right. Be sure you get plenty of fluids and drink when you are thirsty.

Bottle-feeding

We recommend that you use a formula with iron and DHA-ARA. Some of the brand name formulas have started to put prebiotics (and soon probiotics) into their formulas. There is growing evidence that this is good for developing infant gastrointestinal systems. There is no good evidence that this is dangerous if your infant is full term and healthy.

Generic formulas meet national standards and may be a less expensive alternative. When bottle-feeding your baby, make sure you are both comfortably settled. Cradle the baby in your arms or hold him or her lengthwise in your lap, so that the baby’s head and upper back are several inches higher than the hips. Hold the bottle at an angle to keep the nipple full of formula. Most babies should be burped after every 1 to 2 ounces. Sitting your baby upright with his or her back straight for 20 to 30 seconds is usually long enough to produce a burp if one needs to come up. Drinking more slowly and burping more often may help babies who tend to spit up. After feeding, babies may be held or should be placed on their back.

Bottle-fed babies usually drink one and one half to two ounces per feeding every 3 to 4 hours with a gradual increase to 3 to 4 ounces by the end of the first two weeks. Sucking for 20 to 30 minutes should give the baby all he or she needs. Babies who are feeding frequently and well during the day may sleep as long as they want at night.

When making formula, be sure to follow the instructions to ensure proper concentration of formula. Sterilizing water for the formula is not necessary (unless you use well water). If you make one bottle at a time and use warm tap water, there is no reason to heat the formula. If you make a whole batch of bottles at once, you may refrigerate the bottles and use them up to 48 hours from time of mixing. When heating cold formula it is best to use warm water and avoid microwaves. Microwaves can heat unevenly and have caused burns. After heating, make sure you mix the contents of the bottle to distribute all heat evenly and check the temperature before feeding the baby. Bottles do not need to be sterilized. Automatic dishwasher cleaning of bottles and nipples is adequate (but consider if this is desirable given the information on BPA mentioned in the next paragraph).

Plastic Precautions

baby bottles

There has been a lot of controversies recently regarding the safety of polycarbonate plastic containers containing BPA (bisphenol A), a chemical which helps form the strong bond of these tough, clear plastic containers. The scientific community is divided over the safety of BPA in polycarbonate containers. Without conclusive evidence, The Pediatric Center recommends the following common sense approach to plastic safety:

How can parents protect their children from “potential” risks associated with BPA?

  • Most retailers are now selling BPA alternative plastic baby bottles, sippy cups, and water bottles. Look for labels that say “BPA Free”.
  • Don’t microwave – some studies suggest exposure to high heat can dramatically increase leaching of BPA into liquid contents.
  • Don’t wash in dishwasher or extremely hot water (a concern for sterilization of baby bottles.
  • Don’t fill with hot drinks (including formula) or boiling water.
  • Avoid leaving water bottles in the hot sun.
  • Don’t clean with bleaches or harsh detergents, which may cause the plastic bond to break down leaching BPA into liquid contents.
  • Avoid filling with fatty foods or acidic drinks (may also cause the plastic bond to break down).
  • Discard products with visible wear (scratches, cracks, opaque tint).
  • Don’t reuse single-use plastic products (like water bottles and plastic ware).
  • Don’t use plastic wrap in the microwave.
  • While these precautions are especially important for polycarbonate plastics containing BPA, they are also recommended for BPA alternative plastics.

Vitamin D Supplementation

Due to recent studies showing that many US children are vitamin D deficient, the American Academy of Pediatrics has released revised guidelines on vitamin supplements in infants, children, and adolescents.

According to the AAP, vitamin D deficiency is in epidemic proportions in the US. Research shows that sufficient levels of vitamin D are not only important to bone health but also play an important role in the prevention of diseases, including infection, autoimmune diseases, certain forms of cancer and type 2 diabetes. The Pediatric Center joins the AAP in recommending:

  • All breastfed infants (over 2 weeks of age) take 400 IU of vitamin D supplementation daily. This should be continued until the infant is weaned to 1,000 ml (approximately 34 oz) daily of vitamin D fortified formula or whole milk.
  • All infants (over 2 weeks of age) /children/adolescents who drink less than 1,000 ml (approximately 34 oz) daily of formula.

Post-Partum Depression

More than 50% of new mothers experience postpartum blues after delivery. Symptoms include tearfulness, tiredness, sadness, and difficulty thinking clearly. This is probably due to a sudden decrease in hormones and usually resolves over one to three weeks as hormone levels return to normal. Some things to try if you are feeling down:

  • Make sure you are getting adequate rest.
  • Get help with taking care of household chores, cooking, errands, and, if needed, the baby’s needs.
  • Keep in contact with other people so that you do not feel isolated.

Please discuss your feelings with a medical provider or call our office if these feelings become overwhelming.

Some things you might want to know

Basic Baby Care

Babies are Babies! All Babies…

Sneeze, Cough, and May Sound Congested
Sneezing is how the baby cleans his or her nose of mucus, dust or milk. Coughing is often a baby’s way of clearing his or her throat. Your newborn may also sound congested. Mostly this is because infants have to breathe primarily through their noses until about 4 months. (nasal airways are small and soft !)

Hiccup
Hiccups are little spasms of the diaphragm muscle. They often occur after the stomach fills and stimulates the diaphragm.

Are Uncoordinated
Except for sucking, baby’s actions are poorly coordinated. Arms and legs twitch, tremble and move without purpose. Breathing is often irregular and noisy. Babies respond to sudden movements or stimulation with jerky arm and leg movements and crying. This gradually becomes less prominent over months.

Cry
In most instances crying babies need to be held. They need someone with a soothing touch and voice. During the early months of life, too much holding cannot spoil babies. It is, however, normal for a newborn to cry occasionally without reason. In fact, some babies cry in order to fall asleep. When your baby cries make sure that he or she is not hungry and is dry and comfortable. Then if holding your baby does not console him or her, it is fine to let your baby cry for 10 to 15 minutes to see if he or she will fall asleep.

Bathing Baby and Skin Care
Clearwater sponge baths should be given until the umbilical cord has fallen off and the navel is completely dry. Then you can tub-bathe the baby with water and a mild soap such as “Dove.” Frequency is up to you! Many parents (including us) have used a bath as part of a nighttime ritual. Avoid deodorant and highly scented soaps. Most parents wash their baby’s hair once or twice a week with a mild baby shampoo.

Normally, a baby’s skin does not need any ointments or baby oil. If, however, the skin is dry or cracked, apply a white non-scented lotion or creams such as Aveeno, Aquaphor, Moisturel, Eucerin or Keri once or twice a day to damp skin.

Diapers and Diaper Care
Disposable diapers and cloth diapers are both fine for baby.
The baby’s diaper should be changed whenever it gets wet or soiled (although this can be a real challenge at times because a few babies have built-in sensors that tell them it’s time to go right after a fresh diaper has been put on… and you do have to save some money for their college). After removing the diaper, rinse baby’s bottom with a warm wet washcloth. If the baby had a stool, it is ideal to wash him or her in a tub of warm water using a mild soap to make sure that the baby is clean. Baby wipes are convenient and are ok to try but sensitive bottoms will sometimes do better with just warm water and a soft washcloth.

Fingernails and Toenails
Trim the baby’s nails when they bother you or the baby. Use clippers, baby scissors or a nail file. Round off the corners of the fingernails so that baby won’t scratch himself or herself. Cut the toenails straight across to prevent ingrown toenails. It is often easiest to trim fingernails and toenails while the baby is asleep.

Umbilical Cord Care
Try to keep the cord dry. It may take from one to three weeks for the cord to fall off. If during this time you smell a foul odor or there is redness surrounding the cord, please call our office. After the cord falls off, there may be some oozing of fluid or blood that is harmless. Clearwater can be used to clean the cord base once the cord has fallen off. If the area continues to ooze or is raw for more than a few days after the cord falls off, please call our office.

Care of the Male Genitalia
If your baby is uncircumcised you do not need to retract the foreskin of the penis any further than it does naturally. Retraction usually occurs gradually over the first years of life.

If your baby was circumcised, gentle washing of the area with warm water when you change the diaper is all that is necessary. We also think it is a good idea to use Vaseline or A and D on the tip of the penis for the first couple of days to keep it from sticking to the baby’s diaper. During the healing process, it is normal to see yellowish patches over the head of the penis and tiny spots of blood on the diaper.

Care of the Female Genitalia
Baby girls sometimes have a bloody or mucous discharge from the vagina for the first week or two of life. This is normal. It is also normal to have a thick white substance in the inner labia. Some girls have a hymenal tag, an extra tag of skin in the vaginal area. This is also normal. When changing a diaper or bathing the baby, clean the entire labial folds and creases by wiping from front to back. It is not necessary to remove the thick substance.

Baby’s Stools
Baby’s stools initially are sticky, dark greenish-black (meconium). After a few days, the stools become yellow-green and seedy (transitional). Formula-fed babies stools become yellowish curdy to semi-solid within a few days. Breastfed babies have mustardy, more liquid stools. The normal number of stools varies a lot from baby to baby; from one every feeding to one large, soft stool every 5-6 days. Most babies strain, cry and become red-faced when passing a stool. This is normal!

Constipation
Constipation is hard, dried-out pellets of stools. Infrequent stools do not mean that the baby is constipated. If your baby has gone for longer than four to five days with no bowel movement (assuming all else is well), try taking the baby’s temperature rectally. This often stimulates a stool. If that stool is hard and dry or if this does not produce a stool, call our office. Breastfed babies may go 7 to 10 days without having a stool.

Diarrhea
Diarrhea is a marked increase in both the amount of liquid in the stool and/or the frequency of the stools. A diarrhea stool appears to be mostly fluid that soaks into the diaper. Call our office if true diarrhea persists over several hours or if you see blood in the stool.

Sleeping
Newborns normally sleep 16 to 18 hours per day. Your baby will like to be wrapped snugly for the first two or three weeks when sleeping. Babies are used to this snugness from the previous nine months. If possible, have the baby sleep in his or her own room in a standard-sized crib with a firm mattress. Since your baby will spend much of his or her time in the crib, make certain it is safe. Crib bars should be no more than 2 3/8 inches apart. (If you are using an older crib, please make sure you check the distance between the crib bars.) All cribs should be checked for loose or defective crib bars before using. The mattress should be the same size as the crib and should be waterproof. Bumper pads and wedges are unnecessary and can even pose a safety threat. Stuffed toys, pillows and other items should be removed from the crib, as they also pose a hazard to a sleeping baby. Co-sleeping (sharing sleep time in bed with your newborn) can also be dangerous, especially in households where there is smoking.

Sudden infant death syndrome (SIDS) is the sudden and unexplained death of an infant under one year of age. SIDS strikes nearly 5,000 babies in the U.S. every year. One of the most important things you can do to decrease the chance of SIDS is to put your baby on his or her back to sleep. Some other suggestions include:

  • Avoid soft mattresses, pillows, waterbeds and beanbag furniture. Use a firm mattress in a safety-approved crib.
  • Keep the baby’s sleeping area clear of clutter, including stuffed toys and soft bedding.
  • Avoid smoking during pregnancy and keep your baby’s environment as smoke-free as possible.
  • Keep the baby’s room at a comfortable temperature (65º to 68º), and do not wrap the baby in too many blankets.
  • Do not use a hat on a sleeping baby.
  • Bed sharing has not been found to protect against SIDS and according to the American Academy of Pediatrics can be hazardous to the baby’s health.

Clothing
Your baby will be comfortable in the same amount of clothing that you require at any particular time of year. An extra ½ layer would not hurt, but remember that babies can just as easily overheat as they can become cold.

Pacifiers
A pacifier can be useful for soothing babies. The shield should be at least 1½ inches in diameter and the pacifier should be one single piece. Recent studies have shown that babies who use pacifiers at naptime and bedtime throughout the first year of life may have a reduced risk of SIDS.

Going Outdoors
You may take your newborn outdoors whenever the weather is reasonable…but they should be dressed appropriately for the weather…remembering that they do not regulate their body’s temperature as well as they will when they get older. Avoid direct sun — babies sunburn easily and that can be very dangerous. (sunscreen is approved for those of us six months of age and older)

Visitors and Crowds
It is best to keep your baby away from a lot of direct “people” contact, especially in the first two months of life.
If your baby goes with you to crowded places during the first two months of life, a Snugli type carrier is ideal. These carriers keep the baby next to mom or dad and away from other people.
Everyone wants to hold, feed and play with your new baby. Unfortunately, some of these people, especially other children, may have a cold or other infection. Your baby should not be passed around from person to person — you may have to be very firm about this.

If your baby is being held close to you or is in a carriage, is not being picked up or touched by other people, and is not getting a lot of face to face time with people, being in public places is really your choice. The hard part is deciding how to limit direct contact with family and close friends. Everyone draws the line at a different point. Speak to us if you are having a hard time making this call.

When you need a babysitter, a supportive family member or a good friend is often the best solution. Try to avoid leaving the newborn at a place that has older toddler children because of the increased risk of exposure to germs. (Good luck if you have older toddlers at home…..good time to teach them about frequent hand-washing)

Items for you to have at home

Important Items to Have

  • Rectal thermometer. In a normal infant and child, the temperature should range from 97.5 to 100. (Not a fever until over 100.5) Ear thermometers are not very accurate in children less than three years of age but particularly not in newborns. Remember, you are not running a hospital so you do not have to take “routine” temperatures.
  • Cotton balls and cotton swabs (do not use cotton swabs in ear canals).
  • Nasal bulb syringe. A syringe with a soft rubber or plastic blunt tip can be used for cleaning the baby’s nose. (often given to you by the hospital)
  • Normal saline drops to help clean a stuffy nose.
  • Infant Car Seat.
  • Smoke detector located near the baby’s room.
  • Cool mist humidifier (optional)

Helpful Items to Have

  • Automatic swing. A swing can be helpful for soothing fussy or crying babies. Be sure the swing has a sturdy base and crossbars.
  • Snugli or baby carrier. These carriers keep the baby close to mom and dad and safely away from others. If the baby must go with you to crowded places during the first two months, this is a good item to have.

Unnecessary Items

  • Walker. Walkers are not recommended by our practice or by the AAP. Walkers can cause serious injuries and tend to delay infant development (including walking).
  • Baby monitors or intercoms. These devices can interfere with the baby setting his or her own sleep patterns. (You can hear too much!)
  • Baby scales. These scales tend to be inaccurate and daily weights can drive you crazy!

Car Seats and Car Safety

Motor vehicle accidents are the leading cause of death for children under the age of fourteen. Ordinarily a parent’s arms are a very secure place for a child; this is not so in a car. Even if you are wearing a lap and shoulder belt yourself, your child could be wrenched from your grasp by the violent forces of a collision.

Beginning with the very first car ride — the ride home from the hospital — your baby should be secured in a crash tested safety seat. Research on the effectiveness of child safety seats has found them to reduce fatal injuries by 71% for infants and 54% for toddlers. If you do not already own a child safety seat, you can learn more about approved safety seats by using this website to find an appropriate link. Remember, babies must ride in the car-seat facing backwards until they are 24 months old and weigh at least 30 pounds.

How to Tell if Your Infant is Ill

Your infant’s behavior is the best way to tell when he or she is ill. If you suspect your infant is ill, please call the office at 203 327-1055.

The following behaviors are consistent indicators of illness in infants:

Poor Feeding
Occasionally your baby may not want to eat as soon as you expect, but the newborn who completely refuses to eat over a period of 6 to 8 hours is concerning. Poor feeding can also mean a decreased interest or sluggish sucking at times when the baby should be hungry. If poor feeding persists for two or more feedings, please call our office.

Droopiness
Droopiness frequently accompanies poor feeding but can occur by itself. Instead of being active or alert, the baby may seem less strong and vigorous. If limpness or lack of alertness occurs over several hours, please call our office.

Jaundice
Although many babies get a slight yellowish tinge to the skin, this ordinarily disappears in the first week of life. Assess the true color of the baby’s skin by pressing gently on the baby’s chest or back. While the blood is blanched out, note the color of the skin. A truly jaundiced baby will have a noticeable yellow hue. Yellowness in the eyes is not a good indicator of the degree of jaundice. If you are concerned about the baby’s color, please call our office.

Irritability
Babies often have a certain time of day when they are fussier (usually in the evening). It is unusual for a newborn baby to cry continuously for several hours without stopping. Even though fussy, most babies can be temporarily calmed. True irritability occurs when a baby cannot be consoled by rocking or holding or is fussy with any movement. If your baby is irritable, please call our office.

Pimples and Pustules
The baby may have pimples on the face, neck, and shoulders during the first weeks of life. Pimples or blisters in the diaper area, near the base of the umbilical cord, or on arms or legs are not normal. True pimples and pustules are different from erythema toxicum, a normal newborn rash that looks like flea bites and comes and goes. If you see pimples and pustules, please call our office.

Fever
If your baby feels hot and is not overdressed, check his or her temperature rectally. If the temperature is over 100 degrees (or less than 97.5 degrees), please call our office. Tell the person you talk to the temperature you measured and how you took that temperature.

Calling Our Office

If you are concerned about your infant exhibiting any signs of illness, please call our office at any time –day or night – 203 327-1055.