Top Questions About Newborns Answered
By Kristen Bruno, MD
If you’ve got a newborn, you’ve probably got questions. Here, I answer the ones I get most frequently as a pediatrician.
What Can I Do About a Gassy Baby?
All babies make gas and most relieve their gas easily. Gas in infants is usually due to swallowed air, which happens a lot with all the crying that infants do. Many infants feel discomfort with gas pain. You may notice squirming, drawing up legs and crying. Parents worry about how to make babies “less gassy.” Here are a few things that may help a gassy baby find some relief.
- Bicycling legs: Lay baby in his back and move his legs as if pedaling a bicycle.
- Tummy rub: Lay baby on his tummy on flat surface, then gently rub his tummy with your hand.
- Warmth: Lay a warm towel or washcloth over baby’s tummy (on top of clothes), then swaddle infant.
- Feeding position: Keep baby’s head and neck higher than stomach during feeding. If bottle feeding, raise the bottom of the bottle slightly to prevent air from accumulating around the nipple.
- Burp: Frequent burping during and then after feeding
- Gas relief medications: Many parents of gassy babies find probiotics, Mylicon drops and gripe waters give babies relief from gas pains.
If your baby has excessive gas pain that has not responded to some of the above remedies, talk with your doctor about your diet if breastfeeding and your baby’s diet if formula feeding.
How Do I Get My Baby to Sleep at Night?
Newborn babies often do not discriminate between night and day when it comes to sleeping. They run on a 24-hour clock and need to learn early on that night time is for sleeping and eating. New parents need rest, too. Showing your baby a different routine at night so he sleeps between nighttime feedings is important. Here’s how:
- Daytime: Keep shades up to let sunlight in. Lights on. Go for walks. Talk to baby. Babies generally sleep for up to 2 hours at a time during the day.
- Nighttime: Keep room dark. Use a low light—such as a nursing light—to provide minimal light for changing and feeding. When baby wakes to feed, change diaper first then swaddle well and feed, then immediately put baby on back in his sleep place when feeding ends.
Babies sleep for up to 16 hours a day in short 2-3-hour periods. Some babies will sleep through the night at 2-4 months of age. It is important to remember that every baby is different. Switching a baby’s diet—such as switching from breastfeeding to formula—will not help a baby to sleep through the night.
The best way to get your baby to sleep for longer periods at night is to establish a routine early on and stick with it. Babies learn to self-soothe by being laid for sleep drowsy but not asleep. Swaddling, soothing music or sound machines can aid in sleep routines as well.
How Do I Treat Cradle Cap?
Cradle cap (called dandruff in older children and adults) is a thick white or yellow scale that appears in patches on the scalp, behind the ears and in the eyebrows. Researcher believe it is caused by overproduction of oil by glands in the skin. Cradle cap is very common in infants after about two months of age. The condition is harmless to babies but often drives parents crazy. The urge to pick at these greasy scales on the baby’s scalp is a hard one to fight for most parents. Cradle cap can be managed and lessened with some easy home remedies but not cured. It generally resolves by one year of age but can recur in toddler ages for some children.
For temporary relief of cradle cap you can:
- Rub mineral oil, coconut oil or baby oil on baby’s scalp, let sit for 10 minutes then shampoo and gently brush out scales with soft toothbrush or washcloth.
- Use one of many gentle cradle cap shampoos, apply and allow to sit for a few minutes before rinsing
- Talk to your doctor for extreme cases of cradle cap and cradle cap in an older child when medicated shampoos and creams can be considered.
Why Is My Baby Crying?
Crying is a baby’s way of communicating. Babies cry for many reasons and most babies will cry for a total of several hours a day. Crying is distressing to parents who only want their baby to be happy and soothed. When your baby cries, look at the most common reasons for crying and try to address the problem.
Common reasons for crying are: wet or poopy, gassy, hungry, tired, hot or cold. These are generally very easy to address. But babies will sometimes cry for reasons that aren’t so easy for parents to identify. Babies are very sensitive to their environment and often between the ages of 6-8 weeks of age will cry for no apparent reason. Possibly the light is too bright, the dog too loud, your voice too high, the air freshener in the house too vanilla. When you have met all your baby’s needs and he is still crying, it’s time to soothe him. The “5 S” technique developed by Dr. Harvey Karp is my favorite, slam-dunk method to soothe a fussy baby. The basics are sucking, swaddling, shushing, side-lying and swaying.
How Much Should I Feed My Baby?
Every baby is unique when it comes to how much and how often they eat. Breastfed babies eat every 1.5-4 hours and will often cluster some feedings especially in the evenings. Breastfed newborns are encouraged to nurse as often as they want to and for as long as they want in the first few weeks of life while milk supply is being established and mom and baby are learning together. Formula-fed babies typically take at least an ounce of formula every 2-4 hours by the time they leave the hospital. After the first few days most formula-fed babies are taking 2-3 ounces every 2-4 hours. Both formula and breastfed babies need a vitamin D supplement daily. Your pediatrician will let you know when you can stop giving vitamin D but plan on at least 4-6 months.
Some more feeding tips include:
- Start feeding BEFORE your baby cries. It is much easier to get a breastfeeding baby to latch or a bottle-feeding baby to take the bottle if they are calm. Early hunger signs are rooting, putting hand or fist to mouth, opening the mouth or sticking out the tongue and moving the head from side to side. Frantic hungry babies are hard to feed.
- Growth spurts occur around 10 days and again around 3-4 weeks, babies often eat more during these times.
- Young babies sleeping longer stretches at night will often eat more often during the day to make up for missed feedings at night. Your pediatrician will tell you when it is ok to let your baby sleep more than four hours between feedings at night.
- Consider increasing the amount of formula per bottle when your baby is not satisfied at the end of a feeding or when your baby is hungry and wanting another feeding in 1-2 hours.
How Can I Reduce the Risk of SIDS?
SIDS is Sudden Infant Death Syndrome and it’s something all new parents fear. In 2015 there were about 1,600 infant deaths due to SIDS in the United States and 900 infant deaths due to accidental strangulation or suffocation in the bed. Most SIDS deaths occur between one and four months of age and over 90% occur before 6 months of age. SIDS deaths have declined over the last 25 years with the largest drop of 50% after the launch of the “Back to Sleep Campaign.” Ongoing research continues to improve our SIDS knowledge and prevention strategies.
Follow this list until your baby is at least 12 months of age to reduce the risk of SIDS:
1. ALWAYS put your baby to sleep in a safe sleep environment
- Place baby on back to sleep always
- Do not allow baby to sleep in your bed
- Do not allow baby to sleep with other children
- Use a crib, pack-n-play or bassinet with a firm mattress covered with a tight-fitting sheet, no pillows, no blankets, no crib bumpers, no stuffed animals, and no lovies
- Keep your baby’s bed in your room until he is at least 6 months of age (AAP recommends 1 year of age)
2. No smoking
- Do not allow anyone to smoke around the baby.
- Do not have your baby in a room or car where people have recently been smoking.
3. Offer a pacifier
- Offer your baby a pacifier for sleep, you do not need to replace it if baby spits it out at night
- For breastfeeding mothers, introduce the pacifier after the baby has learned to feed.
4. Breastfeed your baby for as long as you can
5. Take your baby to all well visits and vaccinate your baby
6. Watch the temperature
- Do not let your baby get to hot
- Keep the room where your baby sleeps at a comfortable temperature
- Dress your baby in one layer more than you would normally wear. Sleep sacks work well.
Being a first-time parent can be bewildering, but don’t forget: your pediatrician is just a phone call away.