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Newborn Q & A

By June Tester, M.D., MPH
2008-09-25

Q.  I HAVE AN INFECTION IN MY BREAST THAT MY OBSTETRICIAN SAID IS MASTITIS. DO I
HAVE TO STOP BREASTFEEDING UNTIL IT’S GONE?
Absolutely not. You should continue to breastfeed, which will actually help you to get over the
infection faster. While it is normal for your breasts to feel uncomfortable at times when they are full,
a particularly painful area in one breast (especially if you notice any redness around that area) can
be a sign of an infection. Mastitis occurs when milk ducts become engorged and backed up, and
milk leaks into surrounding breast tissue, causing inflammation and creating an opportunity for
infection. Bacteria can also get into breast tissue and cause infection through cracked nipples. Your
physician can prescribe an antibiotic that’s safe to take while breastfeeding, and your baby (and your breast pump) will help by emptying out your milk and relieving that pressure. Applying heat
to the area can accelerate the healing process and reduce the pain.

Q. I HAVE HEARD THAT NEWBORNS NEED TO BE FED EVERY TWO TO THREE HOURS. DOES
THIS MEAN I NEED TO WAKE UP MY BABY IN THE MIDDLE OF THE NIGHT?
Few newborns will actually sleep more than four hours without a feed until they are several weeks
old. In general, until your baby has regained her birth weight, you should wake her for a feed if she
has been sleeping for four hours. Babies typically lose weight initially, but by ten days of age most
are at or above their birth weight. If your baby was born early (before 37 weeks) or is on the small
side, it’s particularly important to make sure that she is getting regular feeds. If your baby is
jaundiced, more frequent feedings will help her to stay hydrated and help eliminate the bilirubin that
is causing the yellowness in her skin.

Q. MY BREASTFED SIX-WEEK-OLD HASN’T HAD ANY BOWEL MOVEMENTS FOR AN ENTIRE
WEEK — DOES THIS MEAN SHE IS CONSTIPATED?
Stool frequency can vary a lot among babies, and can often be the subject of much stress
in new parents as they worry about the color, frequency and consistency of their baby’s bowel
movements. In the first days of life, infants pass meconium stool, which is thick, black and
sticky. (Meconium is actually normal debris such as skin cells that the baby swallows in
the amniotic fluid.) Once all of the meconium passes, stools transition to a soft, seedy
appearance for breastfed babies and firmer brown stools for formula-fed babies. Stool
frequency can range anywhere from once after every feed to once every other day. As long as
the stool is soft and there is no blood, the baby is not constipated. After a few weeks of age,
stooling can become less frequent. Breastfed infants typically have more frequent stools
than formula-fed infants. However, for some breastfed babies, it is not uncommon to have an
entire week go by with no stool – not to worry! This occurs sometimes because breast milk is
absorbed so efficiently.

Q. I HEARD ABOUT TUMMY TIME, BUT AM AFRAID TO HAVE MY CHILD ON HER
STOMACH. ISN’T THAT SUPPOSED TO BE DANGEROUS?
It’s important for your baby to sleep on her back to reduce the risk of Sudden Infant Death
Syndrome (SIDS), otherwise known as crib death. However, this doesn’t mean that she
should be spending all of her time on her back. Babies need to spend time in the tummy-down
position to develop their neck and shoulder muscles, and too much time spent supine (on
their backs) can lead to skull flattening. (Many parents don’t realize that time spent reclined
in an infant seat is also considered to be time spent on the baby’s back.) Whenever your
baby is awake and alert, take the opportunity to place her for a few minutes on her tummy
on a surface like a soft mat or across your lap, alternating the side of the head on which she is
resting. This can be done safely from birth. Babies are able to lift their heads while prone (on their stomachs) at around two months of age, and they will likely participate in tummy time more eagerly if
they are already accustomed to being in this position.

Q. MY MOTHER INSISTS THAT I SHOULD BE CLEANING MY BABY’S UMBILICAL CORD WITH
ALCOHOL SWABS, BUT THE NURSE IN THE HOSPITAL DIDN’T MENTION ANYTHING
ABOUT RUBBING ALCOHOL.
Years ago, parents were instructed to clean around the umbilical cord with rubbing alcohol.
However, we have found that the umbilical stump heals faster without alcohol. The key
is to keep the umbilical stump clean and dry, using just plain water to clean at the base (or
soap and water if it gets soiled). Stick with sponge baths until the stump falls off (usually
within two weeks). Though many parents worry about the cord getting infected, this is
really not all that common. Some crusting or a small amount of blood is a normal finding. If,
however, you see redness or swelling, continued bleeding or any discharge that looks like pus,
you should have it evaluated by your doctor.

June Tester, M.D., M.P.H., is a pediatrician and researcher in Oakland, CA.

Have a question regarding your new baby or parenthood? Send it to us.editor@cwcomms.com.

 

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