WHAT YOU NEED TO KNOW:

What is a well child visit? A well child visit is when your child sees a healthcare provider to prevent health problems. It is a different type of visit than when your child sees a healthcare provider because he is sick. Well child visits are used to track your child's growth and development. It is also a time for you to ask questions and to get information on how to keep your child safe. Write down your questions so you remember to ask them. Your child should have regular well child visits from birth to 17 years.

What development milestones may my newborn reach?

• Respond to sound, faces, and bright objects that are near him
  
  
• Grasp a finger placed in his palm
  
  
• Have rooting and sucking reflexes, and turn his head toward a nipple
  
  
• React in a startled way by throwing his arms and legs out and then curling them in

What can I do when my baby cries? These actions may help calm your baby when he cries:

• Hold your baby skin to skin and rock him, or swaddle him in a soft blanket.
  
  
• Gently pat your baby's back or chest. Stroke or rub his head.
  
  
• Quietly sing or talk to your baby, or play soft, soothing music.
  
  
• Put your baby in his car seat and take him for a drive, or go for a stroller ride.
  
  
• Burp your baby to get rid of extra gas.
  
  
• Give your baby a soothing, warm bath.

What do I need to know about breastfeeding my newborn?

• Breast milk has many benefits for your newborn. Your breasts will first produce colostrum. Colostrum is rich in antibodies (proteins that protect your baby's immune system). Breast milk starts to replace colostrum 2 to 4 days after your baby's birth. Breast milk contains the protein, fat, sugar, vitamins, and minerals that your newborn needs to grow. Breast milk protects your newborn against allergies and infections. It may also decrease your newborn's risk for sudden infant death syndrome (SIDS).
  
  
• Feed your newborn breast milk only for 4 to 6 months. Do not give your newborn anything other than breast milk.
  
  
• Your baby may let you know when he is ready to eat. He may be more awake and may move more. He may put his hands up to his mouth. He may make sucking noises. Crying is normally a late sign that your baby is hungry.
  
  
• Find a comfortable way to hold your baby during breastfeeding. Ask your healthcare provider for more information on how to hold your baby during breastfeeding.
  
  
• Feed your newborn 8 to 12 times each day. He will probably want to drink every 2 to 4 hours. Wake your baby to feed him if he sleeps longer than 4 to 5 hours. If your newborn is sleeping and it is time to feed, lightly rub your finger across his lips. You can also undress him or change his diaper. At 3 to 4 days after birth, your newborn may eat every 1 to 2 hours. Your newborn will return to eating every 2 to 4 hours when he is 1 week old.
  
  
• Your newborn will give you signs when he has had enough to drink. Stop feeding him when he shows signs that he is no longer hungry. He may turn his head away, seal his lips, spit out the nipple, or stop sucking. Your newborn may fall asleep near the end of a feeding. If this happens, do not wake him.
  
  
• Your newborn should have 6 to 8 wet diapers every day. The number of wet diapers will let you know that your newborn is getting enough breast milk. Your newborn may have 3 to 4 bowel movements every day. Your newborn's bowel movements may be loose.
  
  
• Do not give your baby a pacifier until he is 4 to 6 weeks old. The use of a pacifier at this time may make breastfeeding difficult for your baby.
  
  
• Get support and more information about breastfeeding your newborn.
  • American Academy of Pediatrics
    141 Northwest Point Boulevard
    Elk Grove Village , IL 60007-1098
    Phone: 1- 847 - 434-4000
    Web Address: http://www.aap.org
    
  • La Leche League International
    957 North Plum Grove Road
    Schaumburg , IL 60173
    Phone: 1- 847 - 519-7730
    Phone: 1- 800 - 525-3243
    Web Address: http://www.lalecheleague.org
    

What do I need to know about feeding my baby formula?

• Feed your newborn formula only for 4 to 6 months. Do not give your newborn anything other than formula.
  
  
• Ask your healthcare provider which formula to feed your newborn. Your newborn may need formula that contains iron. The different types of formulas include cow's milk, soy, and other formulas. Some formulas are ready to drink, and some need to be mixed with water. Ask your healthcare provider how to prepare your newborn's formula.
  
  
• Your newborn may let you know when he is ready to eat. He may be more awake and may move more. He may put his hands up to his mouth. He may make sucking noises. Crying is normally a late sign that your baby is hungry.
  
  
• Hold your newborn upright during bottle-feeding. You may be comfortable feeding your newborn while sitting in a rocking chair or an armchair. Hold your baby so you can look at each other during feeding. This is a way for you to bond. Put a pillow under your arm for support. Gently wrap your arm around your newborn's upper body, supporting his head with your arm. Be sure your baby's upper body is higher than his lower body. Do not prop a bottle in your newborn's mouth or let him lie flat during feeding. This may cause him to choke.
  
  
• Your newborn will drink about 2 to 4 ounces of formula at each feeding. Your newborn may want to drink a lot one day and not want to drink much the next.
  
  
• Feed your newborn 8 to 12 times each day. He will probably want to drink every 2 to 4 hours. Wake your baby to feed him if he sleeps longer than 4 to 5 hours. If your newborn is sleeping and it is time to feed, lightly rub your finger across his lips. You can also undress him or change his diaper. At 3 to 4 days after birth, your newborn may eat every 1 to 2 hours. Your newborn will return to eating every 2 to 4 hours when he is 1 week old.
  
  
• Your newborn will give you signs when he has had enough to drink. Stop feeding him when he shows signs that he is no longer hungry. He may turn his head away, seal his lips, spit out the nipple, or stop sucking. Your newborn may fall asleep near the end of a feeding. If this happens, do not wake him to finish the formula.
  
  
• Wash bottles and nipples with soap and hot water. Use a bottle brush to help clean the bottle and nipple. Rinse with warm water after cleaning. Let bottles and nipples air dry. Make sure they are completely dry before you store them in cabinets or drawers.

How do I burp my newborn? Burp your newborn when you switch breasts or after every 2 to 3 ounces from a bottle. Burp him again when he is finished eating. Your newborn may spit up when he burps. This is normal. Hold your baby in any of the following positions to help him burp:

• Hold your newborn against your chest or shoulder. Support his bottom with one hand. Use your other hand to pat or rub his back gently.
  
  
• Sit your newborn upright on your lap. Use one hand to support his chest and head. Use the other hand to pat or rub his back.
  
  
• Place your newborn across your lap. He should face down with his head, chest, and belly resting on your lap. Hold him securely with one hand and use your other hand to rub or pat his back.

How should I lay my newborn down to sleep? It is very important to lay your newborn down to sleep in safe surroundings. This can greatly reduce his risk for SIDS. Tell grandparents, babysitters, and anyone else who cares for your newborn the following rules:

• Put your newborn on his back to sleep. Do this every time he sleeps (naps and at night). Do this even if he sleeps more soundly on his stomach or on his side. Your newborn is less likely to choke on spit-up or vomit if he sleeps on his back.
  
  
• Put your newborn on a firm, flat surface to sleep. Your newborn should sleep in a crib, bassinet, or cradle that meets the safety standards of the Consumer Product Safety Commission (CPSC). Do not let him sleep on pillows, waterbeds, soft mattresses, quilts, beanbags, or other soft surfaces. Move him to his bed if he falls asleep in a car seat, stroller, or swing. He may change positions in a sitting device and not be able to breathe well.
  
  
• Put your newborn to sleep in a crib or bassinet that has firm sides. The rails around your newborn's crib should not be more than 2⅜ inches apart. A mesh crib should have small openings less than ¼ of an inch.
  
  
• Put your newborn in his own bed. A crib or bassinet in your room, near your bed, is the safest place for your baby to sleep. Never let him sleep in bed with you. Never let him sleep on a couch or recliner.
  
  
• Do not leave soft objects or loose bedding in his crib. His bed should contain only a mattress covered with a fitted bottom sheet. Use a sheet that is made for the mattress. Do not put pillows, bumpers, comforters, or stuffed animals in his bed. Dress your newborn in a sleep sack or other sleep clothing before you put him down to sleep. Avoid loose blankets. If you must use a blanket, tuck it around the mattress.
  
  
• Do not let your newborn get too hot. Keep the room at a temperature that is comfortable for an adult. Never dress him in more than 1 layer more than you would wear. Do not cover his face or head while he sleeps. Your newborn is too hot if he is sweating or his chest feels hot.
  
  
• Do not raise the head of his bed. Your newborn could slide or roll into a position that makes it hard for him to breathe.

What can I do to keep my newborn safe?

• Do not give your baby medicine unless directed by his healthcare provider. Ask for directions if you do not know how to give the medicine. If your baby misses a dose, do not double the next dose. Ask how to make up the missed dose. Do not give aspirin to children under 18 years of age. Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.
  
  
• Never shake your newborn to stop his crying. This can cause blindness or brain damage. It can be hard to listen to your newborn cry and not be able to calm him down. Place your newborn in his crib or playpen if you feel frustrated or upset. Call a friend or family member and tell them how you feel. Ask for help and take a break if you feel stressed or overwhelmed.
  
  
• Never leave your newborn in a playpen or crib with the drop-side down. Your newborn could fall and be injured. Make sure that the drop-side is locked in place.
  
  
• Always keep one hand on your newborn when you change his diapers or dress him. This will prevent him from falling from a changing table, counter, bed, or couch.
  
  
• Always put your newborn in a rear-facing car seat. The car seat should always be in the back seat. Make sure you have a safety seat that meets the federal safety standards. It is very important to install the safety seat properly in your car and to always use it correctly. The harness and straps should be positioned to prevent your baby's head from falling forward. Ask for more information about newborn safety seats.
  
  
• Do not smoke near your newborn. Do not let anyone else smoke near your newborn. Do not smoke in your home or vehicle. Smoke from cigarettes or cigars can cause asthma or breathing problems in your newborn.
  
  
• Take an infant CPR and first aid class. These classes will help teach you how to care for your baby in an emergency. Ask your baby's healthcare provider where you can take these classes.

What can I do to care for my newborn's skin?

• Sponge bathe your newborn with warm water and a cleanser made for a baby's skin. Do not use baby oil, creams, or ointments. These may irritate your baby's skin or make skin problems worse. Wash your baby's head and scalp every day. This may prevent cradle cap. Do not bathe your baby in a tub or sink until his umbilical cord has fallen off. Ask for more information on sponge bathing your baby.
  
  
• Use moisturizing lotions on your newborn's dry skin. Ask your healthcare provider which lotions are safe to use on your newborn's skin. Do not use powders.
  
  
• Prevent diaper rash. Change your newborn's diaper frequently. Clean your newborn's bottom with a wet washcloth or diaper wipe. Do not use diaper wipes if your baby has a rash or circumcision that has not yet healed. Gently lift both legs and wash his buttocks. Always wipe from front to back. Clean under all skin folds and between creases. Let his skin air dry before you replace his diaper. Ask your newborn's healthcare provider about creams and ointments that are safe to use on his diaper area.
  
  
• Use a wet washcloth or cotton ball to clean the outer part of your newborn's ears. Do not put cotton swabs into your newborn's ears. These can hurt his ears and push earwax in. Earwax should come out of your newborn's ear on its own. Talk to your baby's healthcare provider if you think your baby has too much earwax.
  
  
• Keep your newborn's umbilical cord stump clean and dry. Your baby's umbilical cord stump will dry and fall off in about 7 to 21 days, leaving a bellybutton. If your baby's stump gets dirty from urine or bowel movement, wash it off right away with water. Gently pat the stump dry. This will help prevent infection around your baby's cord stump. Fold the front of the diaper down below the cord stump to let it air dry. Do not cover or pull at the cord stump. Call your newborn's healthcare provider if the stump is red, draining fluid, or has a foul odor.
  
  
• Keep your newborn boy's circumcised area clean. Your baby's penis may have a plastic ring that will come off within 8 days. His penis may be covered with gauze and petroleum jelly. Gently blot or squeeze warm water from a wet cloth or cotton ball onto the penis. Do not use soap or diaper wipes to clean the circumcision area. This could sting or irritate your baby's penis. Your baby's penis should heal in 7 to 10 days.
  
  
• Keep your newborn out of the sun. Your newborn's skin is sensitive. He may be easily burned. Cover your newborn's skin with clothing if you need to take him outside. Keep him in the shade as much as possible. Only apply sunscreen to your baby if there is no shade. Ask your healthcare provider what sunscreen is safe to put on your baby.

How should I clean my newborn's eyes and nose?

• Use a rubber bulb syringe to suction your newborn's nose if he is stuffed up. Point the bulb syringe away from his face and squeeze the bulb to create a vacuum. Gently put the tip into one of your newborn's nostrils. Close the other nostril with your fingers. Release the bulb so that it sucks out the mucus. Repeat if necessary. Boil the syringe for 10 minutes after each use. Do not put your fingers or cotton swabs into your newborn's nose.
  
  
• Massage your newborn's tear ducts as directed. A blocked tear duct is common in newborns. A sign of a blocked tear duct is a yellow sticky discharge in one or both of your newborn's eyes. Your newborn's healthcare provider may show you how to massage your newborn's tear ducts to unplug them. Do not massage your newborn's tear ducts unless his healthcare provider says it is okay.

What can I do to prevent my newborn from getting sick?

• Wash your hands before you touch your newborn. Use an alcohol-based hand sanitizer or soap and water. Wash your hands after you change your newborn's diaper and before you feed him.
  
  
• Ask all visitors to wash their hands before they touch your newborn. Have them use an alcohol-based hand sanitizer or soap and water. Tell friends and family not to visit your newborn if they are sick.
  
  
• Keep your newborn away from crowded places. Do not bring your newborn to crowded places such as the mall, restaurant, or movie theater. Your newborn's immune system is not strong and he can easily get sick.

How can I care for myself and my family during this time?

• Sleep when your baby sleeps. Your baby may eat often during the night. Get rest during the day while your baby sleeps.
  
  
• Ask for help from family and friends. Caring for a newborn can be overwhelming. Talk to your family and friends. Tell them what you need them to do to help you care for your baby.
  
  
• Take time for yourself and your partner. Plan for time alone with your partner. Find ways to relax such as watching a movie, listening to music, or going for a walk together. You and your partner need to be healthy so you can care for your baby.
  
  
• Let your other children help care with the care of your newborn. This will help your other children feel loved and cared about. Let them help you feed the baby or bathe him. Never leave the baby alone with other children.
  
  
• Spend time alone with your other children. Do activities with them that they enjoy. Ask them how they feel about the new baby. Answer any questions or concerns that they have about the new baby. Try to continue family routines.
  
  
• Join a support group. It may be helpful to talk with other new moms.

What do I need to know about my newborn's next well child visit? Your newborn's healthcare provider will tell you when to bring him in again. The next well child visit is usually at 1 or 2 weeks. Contact your newborn's healthcare provider if you have any questions or concerns about his health or care before the next visit.

CARE AGREEMENT:

You have the right to help plan your baby's care. Learn about your baby's health condition and how it may be treated. Discuss treatment options with your baby's caregivers to decide what care you want for your baby.