Mailing Address:
3328 Jenkins Rd, Suite 200
Chattanooga, TN 37421
Phone: (423) 825-4040
Fax: (423) 825-4043
Hours of Operation:
Monday - Friday
9:00am - 5:00pm
Sick Walk Ins:
8:30am - 9:00am
(Current Patients Only)
Emergency Sick:
(Saturday am by appointment only)
Common Subjects / Questions:
Feeding
*Breast feeding: Initially, try to feed every 2-3 hours. The first 24 hours after delivery might be a drowsy time for your baby. Look for at least one void and one stool in the first 24 hours. After your baby is back to birth weight and your milk supply is established you can let your baby wake you at night. Please remember to begin vitamin D supplements for your baby which are available over the counter (D-Vysol, Tri-Vysol). That is the one vitamin breast milk lacks.
*Bottle feeding: Babies generally do well on any of the commercially available formulas. Initially, your baby may only take 1-2 ounces every feeding in the first 24-48 hours but will soon work up to 3 oz. every 3 hours. The first 2 weeks is survival mode, but after that you should be able to gradually establish a routine during the day. Never prop the bottle. Call us if your baby is arching and fussy with feedings or if they choke or cough routinely with feedings. Never give your baby water.
*Solid foods: We will discuss starting solids when your baby is developmentally ready at 4-6 months. At 4 months they develop good head control and their tongue extrusion reflex fades so they are able to accept cereal from a spoon. Many breast feeding moms choose to wait until 6 months to begin solids.
Sleeping
Your baby should always be placed on his/her back in the crib or bassinet. NEVER on their stomach. This is a huge SIDS risk. An infant can sleep 15-20 hours in a day. Try to rotate their head position at night during wakings to prevent a flat head. Swaddling is very helpful for continuous sleep if the baby is swaddled tightly and properly. If you have questions about swaddling, we have handouts with instructions. My recommended sleep book is “Healthy Sleep Habits, Happy Child” by Dr. Weissbluth.
Bathing
Newborns can be bathed each day or every other day using a mild cleanser like Aveeno or Cetaphil. Sponge bathe until the cord has fallen off. Your baby’s skin may appear to be dry and peel but this is normal. You may use an unfragranced lotion like Cetaphil or Aveeno but this is not necessary.
Cough, Sneezing & Hiccups
Babies cough and sneeze to clear their airways. This does not mean they are sick. Hiccups are also just reflexes. You do not need to give the baby water to make them go away. They will go away on their own.
Fussiness & Crying
Infants cry frequently and often without apparent reason. As you get to know your infant better, you will often be able to tell by the cry if he/she is hungry, wet, tired, or just needs to be held. Many babies have a fussy period at approximately the same time each day and this may last until 3 months. Breast fed babies may want to cluster feed during this time (feed frequently) which should be allowed as the milk supply goes down as the day goes on and cluster feeding sometimes precedes a longer period of sleep. You cannot spoil your infant by holding them too much but it is okay to let them cry for short periods of time to start deciphering their cries to see if they are wet, hungry, or have some other need. Often parents take this crying personally. You must remember that a baby’s only form of expression is crying. Don’t let yourself get upset. Take a break if you can.
My recommended book on how to help a fussy baby is “Happiest Baby on the Block” by Dr. Karp.
Umbilical Cord
Clean the cord with alcohol with each diaper change. It is common for there to be a small amount of bleeding, discharge, or foul odor from the cord. Hold pressure for 10 minutes if there is active bleeding. If this does not stop the bleeding, call us. Please call if there is any redness around the cord. As noted above, sponge bathe until the cord has fallen off.
Circumcision
Apply Neosporin or Vaseline to the circumcision with each diaper change until the skin is healed and pink. It is normal for a yellow film to form. If it bleeds, hold pressure for 10 minutes. Call us if this does not stop the bleeding. Wash gently with a mild cleanser during sponge baths.
Jaundice
It is very common for babies to have jaundice. Usually, jaundice will be noticeable the second or third day and peaks on days 3-5. If your baby is jaundiced, place him/her indirect sunlight and feed them frequently. If you notice yellow in the whites of their eyes please call us. Breast feeding infants sometimes will continue to be mildly jaundiced until week 6. This is normal and is due to something intrinsic in the breast milk.
Rashes
Newborns often have different normal rashes. Erythema toxicum is a normal newborn rash that looks like flea bites and comes and goes in different areas. Neonatal acne is caused by maternal hormones and peaks during weeks 4-8. Babies also can have a prickly heat type of rash. None of these are serious and will go away in time. Call us for any blisters, pustules, or severe/ unusual rash.
Diaper Rash
Mild diaper rash is best treated by a thick diaper cream such as Aveeno or Boudreaux Butt Paste. It is helpful to leave their bottoms exposed to air as much as possible. If the rash is red and bumpy, you can try Lotrimin cream over the counter or Nystatin prescription 3-4 times a day. If the rash is raw and ulcerated which is common with breast fed infants, using Maalox mixed with Aquaphor 50/50 topically works well. The antacid properties of the Maalox combined with the barrier properties of the Aquaphor work together to allow the irritation to heal. For breast fed infants, I often suggest starting with Aveeno or Boudreaux pro actively from the beginning with every diaper change and slowly tapering it down if their bottoms hold up. With breast fed infants, no matter how quickly you get their diapers off, the acidity of the stool tends to irritate their bottoms.
Stools
The number of stools per day differs drastically between babies. It may be once every other day or a bowel movement after every feeding. Call us if your baby goes more than 48-72 hours without stool during the newborn period. Breast fed babies normally space out their stooling at 3-8 weeks of age and may even stool only once a week. This is normal as long as the last stool was soft. Green, mucousy stools sometimes with streaks of blood associated with a fussy baby may indicate a milk protein intolerance. Please bring us a stool sample to test for blood.
Spitting Up
Many babies spit up after feeding. This is normal and you should not be concerned unless your infant is not gaining weight appropriately, has pain with spit up episodes, or green or yellow fluid in emesis. Call us if your baby has any of these symptoms with spitting up.
Illness
Crying for long periods, decreased feeding, increased sleeping, and vomiting are all ways your infant may be telling you he/she is sick. If your infant has any of the above symptoms or is just not acting normally to you, take his/her temperature in the bottom. If the rectal temperature is 100.4 or higher and your infant is less than 3 months old call us immediately day or night. Fever in this range is a medical emergency, especially in infants less than 6 weeks old. Please do not give Tylenol; just call.
Carseats
Rear facing carseats in the back seat are recommended until 2 years of age.
When To Go Out In Public
It is best to keep babies at home during their first 6 weeks of life to limit exposure. Also limit visitors, especially young children. No church nurseries or crowded restaurants. Please remember that they do not have a competent immune system yet and cannot fight infection well. Also, remember that if they have a fever of 100.4 rectally, this necessitates a complete work up including blood culture, urine culture, and spinal tap. So, hibernate at home if you can. Walks are fine. Other people are the risk, not the outdoors.
Smoking
No one should ever smoke around your infant. Cigarette smoke has been linked with SIDS, frequent colds, and asthma. All smokers need to smoke outside. If they smell like smoke, they should not hold the baby as this is second hand smoke exposure.
SIDS
Recommendations to prevent SIDS:
We recommend that every parent or caregiver know CPR. Call the American Heart Association for local courses.
Being a parent is hard work. If you have a partner, please remember to take time for yourselves and go out on dates at scheduled times. It is very important not to lose sight of the importance of your relationship during this exciting and rewarding but often exhausting time.
We look forward to partnerring with you during this journey. Please do not hesitate to call during
office hours with any routine questions.
Mailing Address:
3328 Jenkins Rd, Suite 200
Chattanooga, TN 37421
Phone: (423) 825-4040
Fax: (423) 825-4043
Hours of Operation:
Monday - Friday
9:00am - 5:00pm
Sick Walk Ins:
8:30am - 9:00am
(Current Patients Only)
Emergency Sick:
(Saturday am by appointment only)