Bringing a baby into the world can bring so much joy and happiness, but new parents also have many questions and worries about how best to care for their newborn. Between the diaper changes, the feedings, and the all-nighters with the new baby, sanity is at a premium—and whether it's your first baby or your fourth, there are waves of emotions, exhaustion, and a steep learning curve.
Dr. Radhini Bell, a new mom herself and a pediatrician with the UTMB Health Pediatric Primary Care Clinic in Clear Lake, said newborn parenthood is a stressful thing.
“There's something to be said about being a pediatrician and knowing what to expect about childhood illnesses. But now as a mother myself, sometimes my pediatrician hat comes off while my ‘Mom’ hat stays on. And Moms have a lot of worries about their little ones she said.
“I'm still working on how to separate being a pediatrician and being a mom.”
She said she gets many of the same questions from the other moms of newborns who are her patients. She feels it's very important to explain some of the “whys” of caring for a newborn.
“My favorite part of my job is to educate new moms,” she said.
Dr. Bell's top five tips for moms of newborns is below.
A fed baby is a healthy baby.
“We've heard this, but it takes on a new meaning when you are the one who has to worry about whether the baby is feeding properly,” she said. “You just want to be sure the baby is healthy and growing. As a pediatrician, I know that breast milk is amazing, and I set high expectations for myself to provide breast milk to my child. But I went through a lot of emotional and mental struggles that I did not expect.”
She nearly gave up nursing her baby several times but is happy she stayed with it. But it's not the same story for everyone.
“Sometimes formula may be the best option for the child, whether due to poor weight gain or physical/emotional struggles of the breastfeeding mother. Sometimes pumping breast milk is another option as well” she said. “It is important to give yourself grace in these moments and remember that a fed baby is a healthy baby.”
She is happy to offer tips on pumping and what to do about a painful latch. Sometimes, supplementing with formula is necessary, and it's very important that you feel comfortable talking about these options with your pediatrician.
“No one is more invested than you in keeping your baby healthy,” she said. “Everyone has opinions, but trust your Mom gut. Formula is there for a reason, and there are sometimes medical needs for it. Where we go wrong is, we don't listen to mothers. There is no shame in having a conversation about pumping, supplementing, or switching to formula, but we ask that you have this conversation.”
Protect the newborn cocoon.
“When you first bring the baby home, everyone wants to visit, but newborns have a very immature immune system,” Dr. Bell said. “This is why we don't give certain vaccines until they are two months old. The only immunity they have is from their mother or through breast milk.”
Newborns have very tiny airways, so it's easy for even a little cold to clog the lungs and drainage systems.
“This is why we see so many ear infections under the age of 2,” she explained. “During RSV seasons, newborns are packing the hospital beds with breathing issues. So, as parents, you need to advocate for your baby and keep the visitors to a minimum.”
Isolation is not good for anyone's mental health, and family support is critical at this time. Still, it's important to set boundaries with visitors.
“Make sure visitors know the guidelines before they come,” she said. “When they're holding the baby is not the time to give them rules. Insist that visitors wash their hands before touching the baby, and do not kiss the baby, except perhaps on the top of the head or the bottom of the feet.”
Anyone with even a little cold should not come, even if it's just allergies.
“It's not worth the risk,” she said. “What is nothing for an adult could be a hospitalization for a newborn. Wear the baby in a wrap to avoid passing the child from person to person.”
Fevers are worrying, but treat the child, not the number.
Parents are often anxious about fevers, but fevers are a natural way the immune system fights off viruses or bacteria.
“Fevers up to 101°F can be a good thing, and we should allow them, but watch for other symptoms as well,” she said. “If there is a headache or body aches, you can always give pain medicine. But, remember to treat the child, not the number. If the child is running a fever but still eating, sleeping, and running around, you don't have to give them Tylenol. Let the fever do its job.”
However, if the child only has a temperature of 99.5°F but is miserable and not eating, it's appropriate to give them some Tylenol.
“With a higher temperature, there’s a risk of a febrile seizure, which we don't want to happen,” she said. “For infants less than two months old, see the pediatrician for a fever over 100.4°F. The immune system is still very immature, so the baby needs to be seen.”
Babies under six months old cannot have Ibuprofen, Motrin, or Advil—only Tylenol. The dose is based on weight, and Dr. Bell recommends asking the pediatrician for the correct dose of Tylenol based on the baby's weight.
Sudden Infant Death Syndrome
The unthinkable can happen—a healthy baby can die of unknown reasons. It's the last thing a new mom wants to think about, but Dr. Bell said it's critical to know what parents can do to reduce the risk of this tragedy occurring.
“Absolutely do not smoke in the baby's environment,” she said.
Further, she said that a “safe sleep environment” can make a big difference.
“We love to cuddle with the baby, and sleeping in the same room is good for bonding and peace of mind, but do not co-sleep with your infant,” she said. “I need to emphasize why pediatricians say this. Infants do not have muscle control in their faces, necks, or trunk, to move their face from some position that could be suffocating.”
As an exhausted mom holding a baby in her arms in bed, it's easy to see how an arm, a breast, a pillow, or a blanket could suffocate a baby who cannot control their facial or neck muscles yet.
“When the baby or caregiver is falling asleep, you need to transfer the baby into a boring sleep environment,” she said. “This is not a plush, soft mattress. It should be firm, and no stuffed animals or loose blankets, no pillow, nor slight elevation of the head. These could obstruct the airway, so the baby must lie flat. Please do not co-sleep with your baby for these reasons.”
Let's talk about poop.
“Adult constipation is different than infant constipation. Infant constipation is not about frequency, it's about consistency,” she said. “Some infants will poop after every feed, and some will poop only every three days. Both can be normal—what's important is poop color and consistency.”
Black, tarry poop, called meconium, is what passes out of a newborn shortly after birth. It's completely normal, and with milk, the poop should become softer and yellowish.
“That's a normal transition,” Dr. Bell said. “But if a later poop is ever black, white, or red, you need to take a picture of it and see the pediatrician.
Poop consistency should be soft and mushy, like peanut butter.
“It's usually not constipation unless it's coming out in small pellets or balls,” she said. “You may also see the infant straining, sometimes without any poop to show for it. This is also a normal phenomenon. The straining is the baby practicing how to use their anal sphincter and build up their abdominal muscles.”
Dr. Radhini Bell encourages new Moms to find a pediatrician they trust to help guide their child to a safe and healthy upbringing. She is happy to meet expecting parents for prenatal visits free of charge and hopefully take care of your children into young adulthood
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