Q&A Newborn
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Q&A: Newborn

There are many ways to bond with your preemie, and intensive care nurses are well-trained to help you.

Q: I have an infection in my breast that my obstetrician said was mastitis. Do I have to stop breastfeeding until it’s gone?

A: Absolutely not. You should continue to breastfeed, which will actually help you 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 is caused when milk ducts getengorged and backed up, and the milk leaks into surrounding breast tissue, causing inflammation and creating an opportunity for infection. Cracked nipples are also another way for bacteria to get into breast tissue and cause infection. Your physician can prescribe an antibiotic that’s safe to take while breastfeeding, and your baby (and your breast pump) will help you by emptying out your milk and relieving that pressure.

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?

A: 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 tendays 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 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?

A: Stool frequency can vary a lot between 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, and 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 lessfrequent. Usually, breastfed infants 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?

A: It’s important for your baby to sleep on her back to prevent 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.

A: Years ago, parents were instructed to clean around theumbilical cord with rubbing alcohol. However, we have found that the umbilical stump heals faster without the 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.

Q: How can I bond with my premature baby?

A There are many ways to bond with your preemie, and intensive care nursery (ICN) nurses are well-trained and invested in helping you. They can teach you how to touch your baby in a soothing way. (Parents often try to reach out with a light stroke of their finger, but a premie prefers a more firm, cradling touch.) When your baby is doing better, the nurses can help you place him on your chest for skin-to-skin contact (even when he is hooked up to equipment). And when you can’t be there, you can still soothe your baby with your scent. Many nurseries will give you a small piece of fabric that you can tuck in your clothing to get your scent, then keep in your baby’s isolette.

Q: Will it matter if I read to my newborn or not?

A: Your baby has been hearing your voice from the womb for many months now, and likes to hear you talk! Reading a story can be one way for your little one to hear your reassuring voice, but other daily activities like feeding and changing diapers can also be opportunities for verbal bonding, too! You should read to your newborn if you find it to be enjoyable, but you will probably discover that it becomes a lot more fun for you both in a few months, as your baby develops the ability to be more interactive during storytime. In time,your infant will be eagerly watching your lips as you read, taking interest in colors and shapes on the pages, and batting at the book as you flip through it.

Q: Should we circumcise our baby?

A Many parents feel conflicted about circumcision, and the decision can be particularly difficult when they or other family members disagree about what to do. The official stance of the American Academy of Pediatrics (AAP) is that there is no medical reason to necessitate circumcision. Though there is a higher likelihood that an uncircumcised male will develop a urinary tract infection, the risk of him developing one is too small to necessitate that all boys be circumcised routinely. Like any procedure, circumcision carries some risks, most commonly bleeding or infection, but these are rare. A local anesthetic is safe and effective for reducing pain. Overall, the decision is up to parents, and cultural, religious and ethnic reasons are legitimate considerations. For more information, see the AAP Policy Statement: http://aappolicy.aappublications.org.

Will you circumcise your baby? Why or why not? Email us.editor@cwcomms.com

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Written by June Tester, MD, MPH

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