Congratulations on the arrival of your new baby! While this should be a joyful time, it can also be intimidating to care for a baby. You may be filled with first-time worries and wonders, and babies do in fact have health issues that are different from older children or adults. Thankfully, many of these issues are quite innocent, and you will gain confidence quickly in your new role as a parent. The pediatricians and staff of Forest Lane Pediatrics want to guide you in this journey. Click on these links for more information about Newborn Care and Breastfeeding.
Your Newborn, Birth Day to Hospital Discharge Day
- Relax! You’ve worked hard to get to this point! Get as much rest as you can.
- You can expect one of our Pediatricians to come to the hospital to examine the baby within 24 hours of baby’s birth and each day that baby is in the hospital if you delivered at Medical City Dallas, Presbyterian Hospital of Dallas, Presbyterian Hospital of Plano or Baylor Frisco.
- Your baby will probably be awake in the first hour after birth. This is a good time to breastfeed your baby. You will need to nurse on demand, which is typically every 2-3 hours, (between 8 to 12 times every 24 hours) in order to make plenty of milk for your baby. Read more about latching baby in our Learning Center or Stanford School of Medicine's video A Perfect Latch.
- Snuggle with your baby skin-to-skin in order to promote regulation of baby’s heart rate, blood pressure & sugar, improve breastfeeding and reduce stress in mom and baby and more. What is skin-to-skin? Read more about the benefits of skin-to-skin contact on our webpage Breastfeeding – Lactation.
- Even if your baby feeds well immediately after birth, it is common and normal behavior for the baby to be sleepy and not feed as well in the next 8-12 hours after delivery. Don’t worry; your baby will get more hungry and interested soon!
- Your breasts may already be leaking colostrum (a rich, thick, yellowish milk), but even if you are not leaking, your body will begin producing small amounts. It gives your baby a healthy dose of early protection against diseases.
- Your hospital will give you a paper log so that you can keep track of baby’s feeds and diapers. You can also use some Pumping and Breastfeeding Apps for iPhone or Android as well to help you.
- Enjoy getting to know your new baby. There are many unusual physical features in newborns that you may notice; most of these are innocent and normal.
- Be sure to sleep when your baby sleeps!
- At minimum, your baby should have at least one wet diaper in the first 24 hours, and at least one stool (thick, tarry and black called meconium) in the first 36 hours.
- Your baby will continue to drink colostrum at each feeding. A baby’s stomach is still very small at this point – the average amount is between 5-15 mL per feeding.
- It is normal for the baby to sleep heavily. Labor and delivery are hard work!
- Your baby should eat at least every three hours, but more often if baby is showing hunger cues. Read more about hunger cues in our online Library. Some babies like to nuzzle and may be too sleepy to latch well at first. Feedings may be short and disorganized. Your baby will begin to wake up more and has a strong instinct to suck and feed every 1-3 hours, but should not go longer than 3 hours between feedings.
- It is normal for all babies to lose weight in the first week of life, even when feedings are going well. Most babies will lose weight in the first 3-4 days, then plateau for a few days, and then begin gaining weight. Most babies will get back to their birth weight by 2 weeks of age. We do not want babies to lose more than 10% of their birth weight; your pediatrician will monitor this closely and let you know if you need to do anything differently to assist with feeding.
- You will be tired, too. Be sure to rest. It is okay to limit visitors so that you can rest and have uninterrupted time with your baby.
- Your hospital nurse may encourage you to begin pumping if there is not a lot of colostrum or if the baby is having a hard time latching. Be sure to take your tubing from the pump home with you so you can use it again if you need to rent a pump from us!
- Babies are noisy! Sneezes and coughs are normal as it is too early for allergies or illness. Hiccups, squeaks, wiggles, burps, and passing gas are also innocent and normal.
- If you have a boy and have chosen for him to be circumcised, this may be done at any point during your hospital stay. Read more about newborn circumcision and how to care for your son afterwards.
- Expect: At least 1-2 wet diapers & 1 dirty diaper (thick, tarry and black), but some babies have much more.
- The volume of your colostrum is beginning to increase a little, and your breasts may begin to feel a bit heavier toward the end of day 2 or day 3.
- You may feel some nipple tenderness with nursing, but bleeding, cracking or scabbing is not normal. Ask for Lactation help in the hospital if you are experiencing these symptoms.
- Most newborns have some yellowing of the skin, or Jaundice. Jaundice is caused by a chemical called bilirubin. Bilirubin typically reaches its’ peak by the 4th or 5th day after delivery. At low levels, bilirubin is harmless, and usually gets better on its own within the first week or two of life. At higher levels, bilirubin can become harmful, so your physician will monitor it carefully and will tell you if further testing or treatment is necessary. You can read more about Jaundice in Newborns on healthychildren.org.
- Now is a good time to begin the process of adding your baby to your insurance policy. Your insurance company’s paperwork typically has space for you to put baby’s social security number in, but it is not required for you to start the process. You may or may not have “automatic coverage” through your insurance, and our office is happy to help you determine this and explain the process to you. Most insurance companies have a deadline for your to add your baby, and if it is not done in time, you may have a long wait period before you can add baby to your policy.
- If your baby was born by a vaginal delivery, you will usually go home today. See the section below entitled “Discharge Day” for more helpful details about this process.
- Expect: At least 2 wet diapers & 1-2 dirty diapers (looser and yellowish/green).
- Your mature (white) milk may begin to come in. It is normal for it to have a yellow or golden tint first. Your breasts may become harder and sometimes warm to touch, but you may not be experiencing this yet. Feeding frequently (every 2-3 hours during the day) and using cold compresses after nursing will help with the fullness and discomfort (engorgement). Avoid pumping too much during the engorgement period, as this can tell your body to make more milk and increase engorgement symptoms.
- You may begin to hear your baby swallowing milk during nursing.
- You may experience nipple sensitivity, but this should get better within the next day or two.
- Your breasts may begin to leak, which is normal. You may need to wear breast pads in your bra.
- If your baby was born by Cesarean Section, you will usually go home on the 3rd or 4th day after delivery. See the section below entitled “Discharge Day” for more helpful details about this process.
- Expect: 3-6 wet diapers & usually 3 or more dirty diapers (yellowish, soft watery).
- You may be experiencing engorgement (fullness of breasts) as your milk comes in. This can sometimes make the breasts difficult to latch onto for baby, and your nipples may become tender due to baby’s difficulty with the latch. Feeding frequently (every 2-3 hours during the day) and using cold compresses after nursing will help with the fullness and discomfort (engorgement) and reduce inflammation in the breasts.
- Expect: 6 wet diapers & 3 dirty diapers (loose, seedy, yellow).
Discharge Day: You’re going home today!
Here are some tips to help you:
- Call Forest Lane Pediatrics (Dallas 972-284-7770, Plano 972-526-0700) to schedule your newborn visit and lactation consultation (if needed). Your Pediatrician will advise you on what day to come in, but it is typically 2-3 days after you are discharged from the hospital, but potentially sooner if there is concern for jaundice or if the baby is not eating well. We see newborns in the morning, so be sure to call early if you need to call on the same day. At this visit, we will evaluate baby for weight changes, feeding patterns, and assess for Jaundice. You will be able to meet with a Lactation Consultant at this time as well.
- Bring your car seat up to the hospital room to adjust the straps for your baby before leaving the hospital. This can be difficult to do in the back seat of your car!
- Try to time your departure from the hospital shortly after a feeding so that you don’t have a hungry baby in the car on the way home.
- Is your car seat properly installed? Instructions on how to install your car seat can be found on DMV.org "How To Install a Child Safety Seat".
- In the first 90 days of life, a fever of 100.4 degrees Fahrenheit or higher is considered an emergency and requires immediate evaluation in a children’s emergency department. The most accurate way to check a baby’s temperature is with a rectal thermometer. Read about How to Take a Child's Temperature on Healthychildren.org.