Receiving the discharge papers from the hospital can be an exciting time for many parents, but it can also be a stressful time.
There are many concerns and questions that parents will have upon taking baby home, especially first-time parents. The hospital stay is an excellent opportunity to have questions answered and following up with your medical provider at the recommended times should also be taken seriously.
Some medical practices offer daytime nurses who can triage concerns during office hours and may offer on-call telephone services by a physician in the evenings or on the weekends.
Some of the frequent concerns of parents of newborns center around growth and development, feeding, stooling, and sleeping. The following are some general concepts about each of these areas.
Growth and Development:
Your baby will likely lose weight during the hospital stay and in many cases a loss of up to 10 percent total body weight is allowable. By one to two weeks of age your baby should have regained the birth weight and begun to exceed it. The baby should be responsive to visual or auditory stimuli, calm easily when picked up, have periods of wakefulness, and look at his or her caregivers. Parents should contact their pediatric provider if the baby is sluggish in responding to stimuli, not easily consoled or is not making equal movements of the arms and legs.
Breastfeeding is still considered the best feeding option. However, there are numerous brands and specialty formulas available if needed. Breastfed babies will want to nurse for about 20 minutes per breast about every two to three hours, sometimes 10 to12 times a day. Breastfeeding may be very tiring and frustrating at first and persistence and support through lactation counseling is suggested if mom and baby are struggling. Formula fed babies will take one to two ounces of iron-fortified formula every two to four hours. Prepare the formula based on the package instructions.
Don’t place the bottle in the microwave for heating – warm the formula in the bottle by placing it in a large cup or bowl of hot water. Always test the formula to make sure it is not too hot by placing a few drops on the wrist. If your baby has excess spit-up, has poor weight gains, or is excessively gassy, discuss feeding options with your pediatric provider. Parents should store powdered formula at room temperature, prepare formula in a clean environment, clean and sanitize bottles before each use, and discard any uneaten formula. Do not offer infants water or put cereals in the bottles.
If you have concerns about your ability to afford formula, talk to your medical provider and contact community services such as the Women, Infants, and Children (WIC) program and/or Job and Family Services. Mothers should also focus on eating well and try to drink a glass of liquid with every meal and when thirsty, avoid or limit caffeinated products and avoid alcoholic beverages.
Stooling and Voiding:
Parents should expect six to eight urine diapers per day and one to six bowel movements. Breastfed babies will usually stool more than formula fed babies. Stools will be transitioning from the meconium (dark and sticky) to a yellow or green seedy-like loose stool. When changing the diaper of a newborn girl, parents should be aware that there may be some creamy white discharge or some mild bloody streaks; this is generally a normal finding as maternal hormones are circulating in your baby girl.
Your newborn will be sleeping about 16 to 17 hours per day, staying awake for only one or two hours at a time. You should always lay your baby on his or her back to sleep and do not co-sleep. Baby can sleep in a bassinet or crib that can be kept in the parents’ room to assist in observation and feeding.
Do not use loose or soft bedding and do not place objects in the crib. Keep the sides up on the crib if it is an older model. The law now prohibits the retail of cribs that have a drop side. Select a crib that has slats less than or equal to 2 3/8 inches apart. These precautions will decrease your infant’s chance of Sudden Infant Death Syndrome (SIDS) and compliance is highly encouraged.
Your infant should be transported home in a rear-facing car seat, in the back seat, and the strap should be snug. Local fire departments and police departments may be able to assist you with the installation and securing of a car seat in the family vehicle.
Some parents will have ample support from family and friends upon arriving home with their new baby and others may lack support services. Parents can ask favors from trusted friends, neighbors, coworkers, community groups they are involved with, and religious organizations, as needs arise. Accept offers of assistance so that the mother can have time to heal, bond with the baby and maintain as many family routines as possible. Parents will likely receive unwanted advice. Handle this unwanted advice by acknowledging the giver and then change the subject.
Newborns need lots of love and attention from their parents. Be mindful to learn what your baby’s cries mean and how your baby likes to be soothed. Babies respond well to calm environments. If you are feeling stressed, ask for some help. Avoid drinking alcohol and using drugs and try to not smoke (avoid smoking in the home or car). The crib and bassinet are safe places to place the child if a parent needs a short break. Do not ever shake or hit the baby. It is very common for a mother to go through postpartum “blues,” but if these sad feelings persist, contact your medical provider.
The newborn period is a fragile and sensitive time for the rapidly developing infant. Parents should concern themselves with the safety and well-being of their newborn. Limit visitors and avoid others who may be ill (colds, flu, etc.).
Hand washing is very important. Parents should have a thermometer and take the baby’s temperatures rectally as needed; a fever is 38 degrees or higher. If a newborn develops a fever, contact your medical provider. Childproof your home, replace batteries in smoke and gas detectors, and turn water tank temperatures to less than 40 degrees.
One of the most important things is to enjoy this special time with your newborn. Nurturing the infant is not only good for the baby, but for the parents, too. Relax, follow your instincts and watch for baby’s cues.