Important Newborn Questions and Answers

The authors of Heading Home with Your Newborn answer important questions from moms about infant and baby care
heading home pic.jpgPediatricians, moms and authors, Laura A. Jana, MD, FAAP and Jennifer Shu, MD, FAAP offer a wealth of “parent-tested, pediatrician-approved” advice in Heading Home With Your Newborn: From Birth to Reality, Second Edition (American Academy of Pediatrics, September 2010). Available on the American Academy of Pediatrics official Web site for parents, HealthyChildren.org. Also available in bookstores nationwide. Here they answer a few questions from fellow moms:
Question: The new recommendation for rear facing car seats is two years now, not one year. There are moms out there who say, ‘no you switch them as soon as they start kicking the back of the seat, because if there’s an accident they’re going to break their legs’ or ‘I don’t want my seat to get dirty’.
Dr Jana: I’ve actually spent several years as an Instructor in child passenger safety. So there’s almost nothing that we haven’t heard before along those lines. Specific to your question about breaking the legs if they’re going to touch the seat… crash dynamics tell us that when a car is in a crash, everything moves towards the point of the crash, which is usually the front of the car. If they’re in a rear facing car seat, their car seat presses their whole body into the car seat as it moves towards the front of the car. Yes, there is some rebound to the seat, but if you’re in a serious enough crash, even if your child is protected in a car seat, what do you want to protect more, their head and torso or their legs? That becomes a very easy choice in terms of why we keep rear facing longer. Technically the recommendation is to keep kids rear facing as long as possible within the limits of their seat. The bare minimum is 1 year and 20 pounds, and then I always add on; and I don’t know a parent, who when it comes to the safety of their child wants to settle for the bare minimums.
In Heading Home with your Newborn, even though we already had an extensive section on car seat safety in the First Edition, the field has changed so much that we did a huge update on that section of the book with the absolute latest in child passenger safety recommendations. In a book that is meant for new and expecting parents about newborns, we give parents an overview of car seats in general, knowing that it may be the last time that parents read about car seats. We obviously spent the most time on infant car seats and making sure your baby is secured correctly in an infant car seat, because we’re talking about newborns, but we give parents a perspective of what is in their future, because really parents should be dealing with car seats for the next 10-12 years.
Dr Shu: I think where parents might be nervous about something happening to the legs are mostly a theoretical risk. We really don’t see reports of damage to the legs from rear facing car seats, where we do get reports of whiplash and brain damage and death from babies who are forward facing.
Comment: Most instruction manuals should have a set height limit for rear facing.
Dr Jana: In fact you can find those limits on the boxes when you’re walking the aisles of the store. They all very clearly say, once you know what to look for, they will all say ‘rear facing height and weight limits for seats that are meant to be used, rear and forward facing’. The other thing for parents, and partly why we were committed to including that big picture view is, there are some seats that may say they can be used up to 80 pounds, but they’re talking about the entire life of the seat, but rear facing can only be used up to a certain weight, and then it has to be turned face forward. That is something that people want to take into account when they’re buying car seats. If they want to be able to use this longer rear facing, then one of the criteria is to buy a seat that has a higher rear facing height and weight limit.
Question: Are the latch limits in the car seat manual or are they in the car manual?
Dr Jana: You need to look at both, because cars can have limits. Every vehicle has its own individual uses and cannot use recommendations for the vehicle itself. We felt it was so important to include these as a substantial chapter of the car seats, because if you’re going to pick the single most important thing in terms of preventing unintentional injury to children, all the way up to the age of 14, it is going to be motor vehicle crashes.
Question: Do you recommend in your book that parents go ahead and go to the fire station or someplace where they can have their car seat checked out once they have it put together?
Dr Jana: Absolutely, and we tell people where to go on the website, to the National Highway Traffic Safety Administration, to go find by zip code where your closest fitting station is.
If you’d like more information about caring for your infant visit Heading Home with Your Newborn at HealthyChildren.org.
*This post is sponsored by the Role Mommy Writer’s Network.

Important Newborn Questions & Answers

The authors of Heading Home with Your Newborn answer important questions from moms about infant and baby care
heading home pic.jpgPediatricians, moms and authors, Laura A. Jana, MD, FAAP and Jennifer Shu, MD, FAAP offer a wealth of “parent-tested, pediatrician-approved” advice in Heading Home With Your Newborn: From Birth to Reality, Second Edition (American Academy of Pediatrics, September 2010). Available on the American Academy of Pediatrics official Web site for parents, HealthyChildren.org. Also available in bookstores nationwide. Here they answer a few questions from fellow moms:
Question: People often worry about taking a newborn out and you do not want to go to crowded spaces indoors like malls or parties where there could be germs and things like that; but in terms of how they can regulate heat, can they can go out if they are bundled correctly, in the cold for a walk? During the winter season is it best not to have them out and about like that?
Dr Jana: We have an entire section of the book called “Thinking Outside the House”. That is a good example of what people often forget in the Pediatrician books. Where you say; what about the practical? Can I step out of my house? Now all of a sudden my baby seems even smaller because we are going out in the real world. Especially in the very specific new born period – the first three weeks, think of the timeframe when babies really need to wear their hats because their heads lose heat. Here in Nebraska I would not recommend somebody taking a newborn out at the peak of winter. What you find is a lot of new parents do not want to step outside when it is 40 degrees out, because they are afraid it is cold, and there are lots of good accessories to keep drafts from getting in to the where the babies are in the car seats and infant carriers. Just try avoiding extremes temperatures.
Question: What is the most important thing you think parents should know and do before a baby is born?
Dr Shu: One important thing, just from a timing standpoint, you might need to look for childcare as soon as you conceive. Just the reality of a lot of childcare situations is that you have to get on some kind of waiting list to get in to the place of your choice. So I would consider that high on the list. You want to make sure that your financial affairs like insurance are in order. There are so many smart parents I know that just accidentally forget to add their child to their insurance, and they are stuck with a huge bill. That is something you want to put on your To Do list, as soon as that baby has a name and birth date.
Picking a Pediatrician before you deliver is also a really good idea, and that is something we recommend sometime in the early part of the 3rd trimester. The reason for that is you want to hit the ground running and get a head start, rather than play catch up when you have a baby and try to figure out somebody that you have a good fit with. Finally, the most important supplies you will need for having the baby include a car seat which you will need to have once leaving the hospital, something to clothe the baby in, diapers and feeding supplies.
Question: How can you prepare for the birth of a newborn if you wind up delivering early or have an unplanned c-Section?
Dr Jana: Some people have a sense they might deliver earlier, but for a large number of parents, it catches them completely off guard. People often ask as us, when is the best time to read the book? We wanted to make it so that you can start reading it 8 weeks in advance and then pick it up at two in the morning when you have a question with a one week old. The thing that catches people by surprise, most people do not plan on have a C section, most people do not plan on having a premature baby… getting those things that Doctor Shu mentioned really helps take away some of the stress of new parenthood because that unknown is not there anymore.
AAP_Sweepstakes_HouseAd_Final.jpgIf you’d like more information about caring for your infant visit Heading Home with Your Newborn at HealthyChildren.org.
*This post is sponsored by the Role Mommy Writer’s Network.

The Reality of SIDS from the Authors of Heading Home with Your Newborn


Thumbnail image for Thumbnail image for HH2 Final cover lo res.jpgPediatricians, moms and authors, Laura A. Jana, MD, FAAP and Jennifer Shu, MD, FAAP offer a wealth of “parent-tested, pediatrician-approved” advice in Heading Home With Your Newborn: From Birth to Reality, Second Edition (American Academy of Pediatrics, September 2010). Available on the American Academy of Pediatrics official Web site for parents, HealthyChildren.org. Also available in bookstores nationwide.
The following is an excerpt to help you navigate those first crucial weeks of parenthood and caring for a newborn:
The reality of SIDS: Creating a Safe Sleep Environment.
SIDS (Sudden Infant Death Syndrome), sometimes called crib death, is the sudden, unexplained death of an otherwise healthy baby during the first year… there are simple things you can do to create a safer sleep environment for your newborn right from the start.
Be Safe. Play it safe by making sure that you and anyone else who cares for your baby always puts him down to sleep on his back.
Be Firm. This means making sure your baby always sleeps on a firm surface. Make sure your crib meets all safety standards, and that the crib mattress fits securely in the crib. Being firm also means keeping all soft items out of your baby’s crib-including such tempting but potentially dangerous items as fluffy blankets, stuffed animals, and soft or pillow-like bumpers.
Stay Cool. Overheating increases the risk of SIDS. Dress your baby is lightweight sleep clothing.
Clear the air. Keep the air your baby breathes smoke-free, both to reduce the risk of SIDS but also for your babay’s overall health!
Provide a pacifier. During your baby’s first year, consider offering him a pacifier when he is falling asleep. If you are breastfeeding we recommend waiting until nursing is going well (about 1 month) before introducing the pacifier.
Share a room. The AAP recommends sleeping in the same room but not the same bed as your baby for at least the first 6 months. This can make breastfeeding easier while at the same time help protect your baby from SIDS.
*Book excerpt from Heading Home with Your Newborn (Second Edition/Copyright 2010/American Academy of Pediatrics).
The Heading Home with Your Newborn excerpts are sponsored by the Role Mommy Writer’s Network.

The Many Colors of Poop: From the Authors of Heading Home with Your Newborn


Thumbnail image for Thumbnail image for HH2 Final cover lo res.jpgPediatricians, moms and authors, Laura A. Jana, MD, FAAP and Jennifer Shu, MD, FAAP offer a wealth of “parent-tested, pediatrician-approved” advice in Heading Home With Your Newborn: From Birth to Reality, Second Edition (American Academy of Pediatrics, September 2010). Available on the American Academy of Pediatrics official Web site for parents, HealthyChildren.org. Also available in bookstores nationwide.
The following is an excerpt to help you navigate those first crucial weeks of parenthood and caring for a newborn:
The Many Colors of Poop
Long after adjusting to parenthood and your role as principal poop watcher and wiper, you may still find yourself fretting over changes in the color of your baby’s poop. In reality, once your baby has pooped enough to get rid of the tarry meconium, all the varying shades of yellow, brown, and even green are considered perfectly acceptable. Mustardy yellow is the color of choice for most breastfed babies, and yellow-tan with hints of green for those who are formula-fed. Being presented with a changing palette of colors is not uncommon, however, particularly later on down the road when your baby is introduced to such things as solid foods and snotty nose colds, both of which can add new shades and substance to the mix.
Black, White, and Shades of Red
There are a few colors of baby poop that, should you see them, always warrant discussion with your baby’s doctor.
Red. Seeing red can mean blood, especially in the newborn period when your baby isn’t eating or drinking anything red-colored that could be mistaken for blood when it comes out the other end. Blood should not signal you to panic immediately, but you should bring it to the attention of your pediatrician, who will be able to help you sort out the cause. It is possible for babies to swallow some blood during delivery that presents itself shortly thereafter–either in the baby’s spit-up or poop–but, nevertheless, any amount of bloody poop should be evaluated because it can also be a sign of a problem.
Black. Black-colored poop sometimes represents old blood because blood is known to turn from red to black over time in the intestinal tract. Remember that this black color alert does not apply to your baby’s first few meconium bowel movements, which you can fully expect to be black and tarry looking.
White. White poop is quite rare, but needs to be brought to the attention of a doctor ASAP because it can be caused by an underlying liver problem. The earlier it is addressed, the better–either for peace of mind or medical management.
*Book excerpt from Heading Home with Your Newborn (Second Edition/Copyright 2010/American Academy of Pediatrics).
The Heading Home with Your Newborn excerpts are sponsored by the Role Mommy Writer’s Network.

To Bathe or Not to Bathe: From the Authors of Heading Home with Your Newborn


Thumbnail image for Thumbnail image for HH2 Final cover lo res.jpgPediatricians, moms and authors, Laura A. Jana, MD, FAAP and Jennifer Shu, MD, FAAP offer a wealth of “parent-tested, pediatrician-approved” advice in Heading Home With Your Newborn: From Birth to Reality, Second Edition (American Academy of Pediatrics, September 2010). Available on the American Academy of Pediatrics official Web site for parents, HealthyChildren.org. Also available in bookstores nationwide.
The following is an excerpt to help you navigate those first crucial weeks of parenthood and caring for a newborn:
To Bathe or Not to Bathe:
Contrary to popular belief, babies do not need to be bathed every day–especially as newborns. As we enter parenthood, we should all consider ourselves fortunate that we are given a few months in which to become comfortable with our baby-bathing duties before our children effectively figure out how to make themselves truly messy.
It’s really not until babies start crawling around in dirt, sandboxes, or even just on the kitchen floor (depending on how dirty yours is), and begin to explore baby foods–routinely ending up with more smeared on their faces than in their mouths–that they warrant frequent full-body washes. Until then, however, you have the practical option of focusing your attention on a relatively limited number of parts.
Your primary area of focus predictably will be the diaper area–and, of course, the surrounding areas, the size of which will depend on whether your baby has taken to having blowouts. Other areas to pay particular attention to: around the mouth and anywhere there are skin folds.
While some of you may be looking at your newborn and thinking to yourself that there are few, if any, skin folds to be found–rest assured that they will soon appear. The present-from-birth and all-too-often-neglected arm-pit and groin folds are likely to be joined in mere weeks by double chins and thigh folds. If you make a habit of regularly spot-checking these hot spots and cleaning them as needed using a wet washcloth, you really won’t have to bathe your baby every single day. In fact, bathing a couple of times a week is often enough.
*Book excerpt from Heading Home with Your Newborn (Second Edition/Copyright 2010/American Academy of Pediatrics).
The Heading Home with Your Newborn excerpts are sponsored by the Role Mommy Writer’s Network.

Sleeping by the Book: From the Authors of Heading Home with Your Newborn


Thumbnail image for Thumbnail image for HH2 Final cover lo res.jpgPediatricians, moms and authors, Laura A. Jana, MD, FAAP and Jennifer Shu, MD, FAAP offer a wealth of “parent-tested, pediatrician-approved” advice in Heading Home With Your Newborn: From Birth to Reality, Second Edition (American Academy of Pediatrics, September 2010). Available on the American Academy of Pediatrics official Web site for parents, HealthyChildren.org. Also available in bookstores nationwide.
The following are excerpts to help you navigate those first crucial weeks of parenthood and caring for a newborn:
“Sleeping like a baby” can mean different things to different people–usually depending on whether they’ve ever had or taken care of one before. For just about all newborns it fairly predictably means having the ability to sleep at any time and in any place, while at the same time being completely unwilling to entertain any “suggestions” as to how, when, or where to put such talent into practice. You may come across those who have ventured down the path of parenthood before you who simply shake their heads sympathetically and wish you luck in getting your newborn to wake up when you want/need him to, and even better luck getting him to go to sleep when you want. Because we’re committed to helping you set appropriate expectations for yourself and your baby, we’re going to approach the whole subject of sleep by first helping you get into the right frame of mind. We decided to start out by providing you with some basic sleep-related milestones.
Daily sleep. The average newborn spends at least 16 hours a day sleeping, but there can be big differences from one newborn to the next. The total amount of sleep babies need in any given 24-hour day gradually decreases over time, but still totals just over 14 hours at 6 months of age and just under 14 hours at 1 year.
Naps. Sure, many newborns nap in 1- to 2-hour spurts, but before you go planning your schedule around any preconceived idea of nap time, let us add that the length of most newborns’ naps are also very variable and tend to be scattered throughout the day (and night) in a completely random and therefore unpredictable manner. The 3-nap-a-day schedule with which you may be familiar should be considered a sleep pattern you should aspire to down the road, because most newborns don’t settle into this type of nap routine for at least a month or two. Even then, it can take a few additional weeks or months before you can count on a morning, early afternoon, and early evening nap.
Night versus day. During the first few days and weeks of parenthood, you are likely to find that there’s not going to be a whole lot that distinguishes your days from your nights. More often than not, they just seem to blend together into one big sleep-deprived blur. That’s because it will be almost completely up to your newborn when he chooses to be awake and when he chooses to sleep. Most newborns spend equal amounts of time sleeping during the day and night–a tendency that can be quite challenging for those of us accustomed to more of an awake-by-day, asleep-by-night approach. By the end of their first month, most newborns do manage to figure out how to consolidate their sleep into longer stretches and start to get at least one extended stretch of sleep each 24-hour day. So with any luck, you’ll be blessed with a baby who decides to choose nighttime as the right time to do so. And for the real light at the end of the tunnel: By 3 months of age, many babies get approximately two-thirds of their total daily sleep during the night.
*Book excerpt from Heading Home with Your Newborn (Second Edition/Copyright 2010/American Academy of Pediatrics).
The Heading Home with Your Newborn excerpts are sponsored by the Role Mommy Writer’s Network.