Labor, Delivery & Life Beyond

Pregnancy Health & Complications

Preparing For Your Baby

Stages of Your Pregnancy


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Podcast Details:

15.90 MB | 39:51 Min

Experts In This Episode:

Dr. Sara Rizvi is a Pediatrician and Assistant Professor of Pediatrics at Baylor College of Medicine, one of the nation’s top medical schools.


Welcome to your Pea in the Podcast, I’m Bonnie Petrie with everything you need to know about your body, your baby and the big changes ahead in your life as you begin your journey to becoming a mommy.

This week it’s what your pregnancy has been all about, your baby. But you may have surprises in store…

“Their appearance is probably the thing that is the most striking as a parent.”

And you may have many, many questions from how to care for your baby’s belly button to whether you should circumcise…

“Circumcision is really a parent’s choice.”

How much crying is normal?

“Colic is usually a baby who is especially fussy.”

And can you spoil your baby?

Get a glass of water and a snack and get comfortable. This is a long one; we have a brilliant pediatrician from Baylor College of Medicine here today to answer those questions and to help you learn to care for your newborn in this Pea in the Podcast.

Your baby has arrived, a beautiful bundle of joy. But now what? They’re going to let you take this person home with you, without a test or a manual. Breathe. We have an expert to answer your most important questions; Dr. Sara Rizvi from the Baylor College of Medicine is here.

Dr. Rizvi says your first surprise may be your baby’s appearance when they arrive.

“They don’t look like your typical 1 month old baby or even a 2 week old baby. They may have some bruising at the scalp; they may have some venous engorgement of the face, those sorts of unusual characteristics that go away in about a week or two.”

What can I say, they just completed the most difficult journey of their lives, whether it be vaginal birth or c-section.

Also remember they’ve been living in liquid for 40 weeks or so so their skin is sensitive in their new environment.

“Newborn skin is very, very delicate and some babies will have you know different types of rashes, they may have plugged up sebaceous glands particularly around the nose area and the cheeks. Some babies will have a full rash we call erythema toxicum which appears as a spotted rash all over the body, very blotchy looking. And again it’s so individual, some babies will have it and some babies won’t.”

But regardless their skin will become acclimated to their new world over time.

Some of you may be surprised if you baby appears cross eyed. Don’t be.

“Babies can appear to be crossed eyed we call that pseudostrabismus — or false cross eyed — whereas they are actually not really crossed eyed but it is the appearance of that, due to the appearance of the eye lids and their relationship to the nasal bridge. Your doctor is able to look at the baby and be able to tell by the reference of light in the light whether or not this pseudostrabismus or real actually strabismus cross eye.”

Sometimes this cross eyed appearance will last for months. It did in my baby, although she only occasionally looked cross eyed, and our pediatrician assured us this was normal and would ease with time and it did. Her eyes are perfect now.

One thing you should try to do when your baby comes is nurse as soon as you can.

“I think it is essential. I think it is very important for the baby to nurse in the first few hours past the delivery. It is safe for them to do so and especially, you know, for breastfeeding mothers who want to start breastfeeding, that is the right time to start. It’s good for baby, it’s good for mom and it gets everybody started on the right foot.”

They call colostrum liquid gold. It helps seal your baby’s digestive tract and offers protection from later food sensitivities. Colostrum is great stuff, so even if you don’t think you want to nurse long term it is worth it to try to give them this. There isn’t too much of it. This nutritional punch is packed in very small doses. Dr. Rizvi explains…

“Your milk let down is initially colostrum. It is thin. It is watery. It is very different from breast milk which will come in about 3-4 days later, so a common complaint we hear from mothers in the first few days is I don’t feel like I’m getting a lot of milk out and I’m not sure the baby is getting enough. So rest assured, as long as the baby is having good urine output and appears well and is, you know, gaining weight well and not losing a significant amount of weight, that they are getting what they need, and moms should be very comfortable that when colostrum is coming out it is the appropriate amount and baby is doing fine with that.”

So we’re watching for wet diapers in the beginning of the baby’s life. Weight won’t tell you what you want to know but wet diapers will.

Why don’t we rely on weight? Well, babies lose quite a bit of it after they’re born.

“The first week of life it’s normal for them to lose up to around about 10% of their body weight and that is because they are losing some of that excess water that their tissues retained while they were in the uterus, in the womb. So they get rid of that water in the first week of life and that is seen as weight loss. One of the things we do when we see them for their newborn check-up at 2 weeks of age is we check to make sure that by that period time they have gained some weight and they should be at or very near to their birth weight by 2 weeks of age.”

Many times immediately after a baby is born they’ll have a time of quiet alertness.

“They do tend to open their eyes and you know gaze a little bit at the surroundings and move their limbs and things. They really can’t see very well so they’re not able to fix on a face and really recognize faces unless it’s extremely close to them. But they are interacting with their world. But most babies very shortly after birth they are ready to go to sleep, especially if they fed.”

Enjoy this quiet alertness; use it to nurse and bond because newborn babies do sleep a lot. Many times they will fall asleep not long into a feeding and they’ll find you’ll have to do things to wake them up to finish, take off their clothes or wipe them down with a warm wet cloth. It is amazing that you can get so sleep deprived when babies sleep so much. But they sleep in short bursts and they wake up hungry so you’ll find that you never get the 8 hours you’re used to. Don’t worry, mommy, it doesn’t last forever, but it does last for a while.

Immediately after your baby is born they will meet a pediatrician for the first time. This is what happens medically after your baby comes.

“The pediatrician assesses the baby to make sure that they are breathing okay, that they are not having any problems and that is where the APGAR scores come from. Those numbers that you get really just let us know whether or not the baby is doing okay and whether or not they need resuscitation. So that is done in the first 5 minutes. The first score is given at 1 minute after birth and the second score after 5 minutes after birth. After that period of time we’re cleaning off their skin and then they are taken into the nursery where they are weighed, we’re also putting drops into their eyes to protect from infection. It’s not uncommon for the nurse to also check their blood sugar and just make sure that they are not having any problems or very low blood sugar, particularly if the baby was born to a diabetic mother, then we’re a little bit vigilant about the baby making sure the baby is not having low blood sugar. But those are the things that are done in the first hour after birth.”

So your baby packs a lot of living into those first hours. Then it is just you and your baby and your partner. Your baby may stay in the room with you, mine did. And your partner may also stay in the room with you. You may be stressed and strung out. I was, but I was also passionate about being with my baby. Remember if you’re nursing to line up some help and some support for your stay in the hospital. Hospital lactation consultants are busy and they may not be able to get to you for a while. And nurses well they may not be able to be helpful for whatever reason. I found myself trying to teach myself how to nurse, and that was a little difficult. Next time I will be ready with a support system, whether it is an experienced friend or a lactation consultant or a post-partum doula or someone from La Leche League, but be ready, newborns eat often whether they are nursing or bottle feeding. Those little tummies empty quickly. You may feel like sometimes all you do is feed the baby. That’s normal and it doesn’t last forever.

Some of you, new parents to boys, may be faced with a decision about whether to circumcise.

“Circumcision is really a parent’s choice. There is no medical indication for circumcision of a newborn. That’s really done more for cosmetic reasons. It doesn’t decrease the number of urinary tract infections. That was a popular theory many, many years ago where the thought was perhaps circumcision might cause decreased urinary infections in children and young boys but the evidence has not suggested that circumcision prevent any urinary tract infections. So really it is up to parents whether or not they want to circumcise their child.”

In fact, some say circumcision became popular in America because some people thought it would encourage little boys to keep their hands off. We all know how well that worked! ;)

But if you want to circumcise your baby, it’s totally up to you. Dr. Rizvi says talk to your pediatrician before your baby is born. They can give you all of the information you need.

“That’s a good time to really familiarize yourself with what circumcision is, what you are going to have to do afterward for care and also what you would need to do if you choose not to circumcise your baby. Routine care is very easy to do and it’s important to know that the foreskin is an actual part of the penis. It’s not without its anatomic purpose. It’s actually protecting the top of the penis from urine and feces and other types of irritation. And it’s a little bit sensitive protection for the top of the penis. So it does have a purpose, and so if parents choose not to circumcise their baby they should feel comfortable and feel that their pediatrician can talk to them about what they need to do for care. It’s not complicated, it’s very simple. But it can be confusing to parents if no one explains it to them.”

Some people circumcise because they say they want their baby’s penis to look like their daddy’s penis but keep in mind no baby boys penis is ever going to look like a grown man’s penis, circumcised or not. So if you do decide to circumcise.

“The way that most pediatricians will do it, they will use a local anesthetic, it’s very quick and the after care is simply keeping it clean, using the antibiotic ointment so the area heals.”

One thing I will say if you decide not to circumcise your baby…do not push back the foreskin ever. Clean around it, but if you force it back it can lead to a condition that could someday mean your baby has to get a circumcision when they are older. Don’t mess around with it. It will eventually retract on its own.

Another thing that requires some care when you get home is your baby’s belly button. Simply wash and dry it…just keep it clean and dry. That is really all you need to do.

“It’s normal for the base of the cord to have a yellowish appearance, that’s actually what we call the Wharton jelly or the actual area of the cord and that’s the area that needs to be dried very well. You don’t need to soak it in any type alcohol; you don’t need to apply lots. It’s fine if you want to use a simple alcohol wipe to just clean the area and simply dry it. That’s okay as well. I leave that up to parents, but they don’t need to soak a cotton ball and really immerse the cord in that. Just really keeping it dry is all they need to do. Watch for signs of infection, which would be redness of the skin of the belly around the cord. That would be an indication of a potential infection of the cord, but it is very rare. Normally the cord will dry up and tends to fall off in the first 2-4 weeks of life.”

One time you might want to use that alcohol wipe is if your baby has a blow-out that results in, yeah, poop on the cord. Sometimes it happens! Just clean it up as well as you can and let it dry. By the way some newborn diapers have an area cut out for the cord stump, some don’t, or if you’re going to use cloth diapers you can fold the diaper down to leave the cord exposed to the air.

Bathing. I waited a week to bathe my baby until my mother-in-law came and did it. It is amazing how terrifying 6 pounds of baby can be. I didn’t want to drop her, and really you don’t need to bathe them all that much. And when you do, be gentle.

“Their skin is sensitive and it does matter what you bathe baby with. It should be perfume and dye free baby wash or a very mild soap, Ivory white bar soap or Dove bar soap that’s free of perfumes and dyes. And they don’t really need to be bathed every day, you’re already cleaning them when you’re changing diapers so you’re really cleaning the part of the body that is getting dirty when you’re doing that.”

One area that you might forget to wash is their neck. You should take a wipe there every now and then. Those little folds of skin can get nasty with all of the dribbling going on so even if you don’t bathe every day make sure to keep their bottoms and their necks clean.

And speaking of bottoms…

“Babies have a reflex called the gastrocolic reflex that every time they eat when their stomach is full their stomachs empty and they poop. So it’s not uncommon most parents tell me, my baby poops every time I feed them they poop a diaper, and that’s normal. And so upwards of 10 times a day that’s normal, very, very normal. The more the better. And same thing is true of urine output. They should have very frequent urine wet diapers throughout the day. That indicates a good hydration status. If they’re getting enough fluid, and so you know a few diapers, a few wet diapers a day and several diapers with poop a day you can reassured your baby is doing well.”

You may find yourself getting obsessed with your baby’s poop. It is fascinating stuff.

“What I tell parents is that it can be any color of the rainbow. It really depends to some degree on their diet, so whether or not they are taking formula versus breast milk, that’s going to change the consistency of the stool, and we tend to see that babies who are breastfed may have slightly looser stool. Sometimes babies who are breastfed will absorb so much of the nutrients from breast milk that they won’t have as much stool outside, they won’t have as frequent stool, and mothers may get concerned when a baby hasn’t stooled in a few days, but they are not constipated. And that’s simply because they are absorbing all of the nutrition from the milk. Babies who are formula fed this will have a slightly different consistency, a different odor to it and maybe a different color.”

“In the first few days of life generally babies will pass meconium which is essentially a stool made with a sort of thick, gummy consistency and what that is made of is fluid they were swallowing in utero and various placental cells and things that they may have ingested while in utero and that is what the components of meconium are. That’s why it is so different from the stool that occurs later on. Any of those things are normal.”

Formula fed babies tend to get constipated, while breastfed babies frequently have poop the color and consistency of brown mustard, and that stuff can come out with force. When my daughter was about 5 weeks old we were getting her pictures taken at a studio that was all white including white carpets and when her father was changing her she pooped and it looked someone had stomped on a squirt bottle of mustard. It shot across the room, covered the carpet and her father. I was laughing too hard to really help clean up much, so beware of projectile poop.

Some babies get a little yellow after they are born. That is called jaundice.

“I would say at least 3 out of every 4 babies that are born will become jaundice at some point after birth. This is simply because in the womb or in utero they have a lot more red blood cells than they need when they are born, and that’s because again because they are receiving their nutrition from the placental blood supply, so they are using red blood cells to kind of transport nutrition to their own body cells. They have a lot more red blood cells when they are born than they are going to need later on in life. So those red blood cells need to break down in the first few days of life and one of the chemicals that is released when those blood cells break down is called bilirubin.”

“Bilirubin is actually converted to another chemical through the liver, and that’s how the body excretes it, in the stool. And unfortunately, in babies, their liver sometimes can’t keep up with the supply of bilirubin that is being presented to it. What happens is some of that bilirubin deposits the skin, and that’s what causes that yellow color you see. So it is very, very common.”

“The things that we really are concerned about is if the level gets extremely high and that’s in very rare cases. It levels get extremely high there is a risk for bilirubin to deposit in the brain, certain areas of the brain causing (damage to the brain) that can be permanent. So that’s why we check the bilirubin levels when we see a baby getting jaundiced. But it’s a very, very rare occurrence that the level gets high enough starting to be for a neurologic problem.” We start light therapy at a very low number but most babies don’t even need light therapy. They simply need to feed frequently and give it a little time to pass.”

This type of jaundice is called physiologic jaundice and some of you may get the very bad advice to stop breastfeeding if your baby has this type of jaundice, when all you need to do is nurse more. Mother’s milk has a laxative affect, and your baby needs to poop to get rid of the bilirubin, so nurse, nurse, nurse!

There is one kind of jaundice, though, that may be your baby may get later that may require a very brief pause in nursing. That’s called breast milk jaundice.

“In some cases where the bilirubin is very high, in those cases you might recommend withhold breastfeeding for a period of only about 24-hours, and then resume. That is only in the cases of breastfeeding jaundice where the levels are high enough that we need to hold breastfeeding for 24-hours. Very rarely do we do that. For physiologic jaundice we never recommend you stop breastfeeding. We always recommend, in fact that breastfeeding is good. To simply breastfeed frequently to avoid the baby getting dehydrated and to help them make a nice amount of urine and a nice amount of stool. They can help you get rid of that bilirubin.”

Some of you may notice a little bit of blood in your baby’s poop. This warrants a call to your doctor.

“Blood in the stool could be a sign that baby is having trouble tolerating some of the protein, such as milk protein in the formula. I wouldn’t say that it is necessarily more common in formula fed versus breastfed babies because breastfed babies can also have problems with milk protein intolerance, if mother is taking in dairy. But again some babies do have problems tolerating formula. I can’t stress enough how as a pediatrician we always recommend that breastfeeding is absolutely the best thing for any parent to do and it’s cheaper than giving formula over the long run. There is an economic benefit incentive to parents as well, but it is so essential for babies to get that colostrum in the first few days of life, it’s got very protective antibodies that helps little babies’ immune systems. And the nutrients from the breast milk are what we call very bio available which means they are easily absorbed, easily digested and the babies tend to gain weight better on breast milk and it can put on the kind of fat that they need to help build their nerves and their brains and their bodies.”

If you are formula feeding and have blood in the stool your doc may suggest you go to hypoallergenic formula, those are really expensive. I know. My baby was on that in addition to breastfeeding. But going to a soy formula probably won’t do you any good because cow’s milk protein intolerant babies are very often intolerant of soy protein. Also going to a lactose free formula, that won’t help you either because lactose is cow’s milk sugar and these babies are intolerant of cow’s milk protein. If you’re breastfeeding and find blood in the stool you should try cutting dairy out of your diet. It’s not fun but it can be done. I did it and it will make for a happier baby which is worth it. They might actually sleep!

That brings us to my single greatest fear during pregnancy. Oh yeah. Colic.

“The definition of colic varies depending upon who you’re talking to. But in general I think we tend to agree that colic is really a baby who is especially fussy. So we’re not talking about a baby who just wakes up and cries for a feeding. We’re talking about a baby who cries excessively, especially after feeding, and is really inconsolable for a long period of time. And that can be very frustrating to parents. One of things that recommend to parents with colicky babies is look at if mom is breastfeeding, look at what she is eating and make sure you minimize dairy, minimize gas producing food because those things can actually sometimes be passed through breast milk causing the baby to have a lot of gas. Sometimes excessive gas is a cause of colic.”

“In some babies that get labeled colicky what we actually end up finding out is they have reflux and significant amount of reflux that they may need to be treated. So for some colicky babies it may not be gas, it may be reflux. And again other babies who have colic sometimes they are diagnosed a problem with formula such a as a cow’s milk protein colic.”

Some people define colic as inconsolable crying that comes on at 3 weeks at age and lasts for 3 hours a day and ends at 3 months. Obviously every baby is different, so that definition has to be a little bit flexible, and that would be the kind of colic you get if your baby’s new nervous system is over stimulated. Newborns do their best without a lot of stimulation, so put that baby Einstein away for a couple of months and be careful about Aunt Mildred passing the baby around to 100 different aunts and uncles and cousins.

Reflux can also be caused by cow’s milk protein intolerance, but it can also be just a result of a baby’s immature digestive system. Here are some things that you can do to ease your baby’s pain, starting with your baby’s sleeping area…

“The base of the crib is sometimes adjustable to a 30 degree angle. Putting it at a little bit of an angle helps and then also making sure that baby is upright for 30 minutes after a feeding.”

My baby had cow’s milk protein intolerance reflux and consequently colic on steroids, my worst nightmare realized. She slept best in her baby papasan chair and in my arms.

Sometimes babies who don’t spit up have what is called silent reflux. They’ll have all of the other symptoms of reflux but they won’t actually spit up. It won’t make it all of the way up to their mouth, but it does go up and burns their throat along the way.

Sometimes babies who spit up a lot don’t have reflux.

“All babies spit up and some babies will spit up with every feeding and as long as they gain weight we don’t need to treat them with medications for reflux. What we do if they have significant spitting up, if they start to lose weight then we really consider that they have reflux disease instead of the just normal spitting up.”

Babies who spit up with no pain or weight loss are called happy spitters, no medications necessary. Just lots of onesies and lots of laundry detergent.

I talked about my worst fear being having a colicky baby, but of course that is not true, every mom is terrified that one day she will walk into her baby’s room and she won’t be able to wake them up. Of course we’re afraid of SIDS.

“SIDS is Sudden Infant Death Syndrome and it can be due to a number of different causes. We don’t really know what causes SIDS. It’s probably a combination of a lot of different diagnosis and problems in babies. Some babies may have had a medical reason for sudden death such as a heart problem, or a lung problem, or a brain problem, those sorts of things and that may be diagnosed later on after the sudden infant death. In some cases we never find out why they died.”

“So there was a lot of effort, a lot of research put into what seems to impact the number of SIDS cases and the only thing that has come out of that has been placing babies on their backs to sleep. The thought is that in some cases of SIDS it may be due to infant smothering, and a newborn infant up to about the time they are 4 to 5 months of age, they are not able to roll over. So they’re not able to right themselves. If you place them on their tummy and their face is smothering in a pillow or in the blanket or in the mattress of the crib they are not able to turn themselves to the side and turn over and roll over and get out of that position.”

So put your baby on their back to sleep.

“Not on their side, not propped with pillows, not with pillows on any sides of them either, but simply on their back to sleep with just a minimal light blanket, if anything. It is important also not to stuff the crib with lots of stuffed animal toys or other pillows. Don’t put a very fluffy pillow underneath the blanket or on top of the mattress pad because all of those can also be a smothering risk.”

That includes no bumpers. They are cute, and all, but your baby can press their little face against them and rebreathe carbon monoxide. That’s another suspected trigger for SIDS. Also there is some evidence that people who smoke near the baby, well, that increases your baby’s risk for SIDS, and there are some evidence that moms who breastfeed their babies, well, their babies have a lower risk for SIDS.

Some of you will find that your baby will not be too happy sleeping on their back.

“Some babies may be fussy when they are placed on their back but it may not be actually the position of being on their back it may be actually they shouldn’t be lying down 30 minutes after feeding because they experience some reflux and that may be where some babies get a little bit fussy.”

Also some babies just maybe having trouble adjusting to life outside the womb. Think about it. For months they have been cramped into the fetal position all snug and warm, listening to your voice and your heartbeat and it’s pretty noisy in the womb. They’ve been in the dark, and this place out here is bright and cold and they are no long all snug and warm. These babies may sleep better with a nice, tight swaddle.

“Babies can be swaddled with a blanket again it should be just a light blanket and actually the baby is wrapped in a baby bundle and that is fine, that is okay. Again placing them on their back to sleep while wrapped in that blanket.”

Your hospital nurse can show you how to do one; it’s really easy to make a swaddle. Receiving blankets are perfect for this.

Dr. Harvey Karp who wrote the book The Happiest Baby on the Block, well, he calls the first 3 months of the baby’s life the fourth trimester. Little ones do best when they’re held tight, snuggled in close to your heart, talked to and loved. They are getting used to this new place and it takes a little bit of time. Be patient.

There is one possible drawback to back to sleep you should be aware of.

“We did start to see a slight increase, not very significant but a slight increase in the number of babies that we saw later on with a little bit of flattening in the back of the head. We call it positional plagiocephaly and that is simply come on because being on their back to sleep. They’re not going to roll over and so if they’re sleeping for a significant period of time, which they are in the first few months of life, they’re spending a lot of time with their back of their head against the base of the crib. The good news for that is that once baby starts to get more mobile and they are able to roll side to side, which is about 4 months of age, and they are able to sit up, which is about 6 months of age, that positional plagiocephaly will usually resolve itself without any treatment. There’s a small subset of babies that may need some treatment later on if it hasn’t resolved at usually 6-9 months of age and the treatment is simply a little helmet that will put the proper pressure to the various cranial bones and help push the head into place into normal alignment.”

Sleeping through the night. Your mother-in-law or that know-it-all woman at the park or the woman in the cubicle next to you may insist their baby reached that much longer for milestone at like 3 days old or something. She’s probably lying, and anyway, that would be actually a bad thing at that young age.

“In the first 4 months of life babies wake up to feed and they will need to feed at night. They cannot go through the entire night without feeding, and if they do they run the risk of having extremely low blood sugar, which can lead to seizures and other problems. So it’s very important to respond when baby is crying. Usually it’s around 4 months of age where baby is going to be able to sleep through the night without a feeding. So it’s important for parents to know that that is normal behavior for the baby. Babies are not trying to be difficult. Developmentally that is appropriate for baby to cry and need to feed at night.”

And, in fact, before your baby is 4 months old you should always respond when they cry. That’s the only way babies have to communicate, and when they are crying they need something. They really do, whether it’s food or a diaper change or just some affection, and yes, babies need affection. They need physical contact, they just don’t want it, they need it to develop normally. So when they cry, respond.

“It’s very different when the baby is much older you know then we’re dealing with things of letting them sleep in their own crib and that sort of thing, and that’s a much older baby we’re talking about and definitely not a younger than 4 months baby.”

So when someone tells you to leave your infant to cry you can smile and nod…and ignore them. Your baby’s lungs don’t need the exercise and your baby is not trying to manipulate you. If they are crying they need you.

This is not to say you can’t leave them to fuss a little while you pee or make a sandwich, just don’t leave them crying for extended periods of time. This is when babies learn to form bonds and learn to trust. If their needs are met quickly, they will likely cry less when they are older and they will be more independent because they have this confidence that their needs will be met, that you are there for them. They learn this when you respond to them quickly, when they are small.

So all of this brings us to our 2-week appointment with a pediatrician. What you haven’t hired your pediatrician yet? Start asking around.

“I always tell parents if you’re expecting not only should you choose an OBGYN but you should choose your pediatrician at that time, as well, because it gives you a chance to really interview them and make sure they are a good fit for you and your future baby.”

So what happens at this 2-week appointment?

“It’s really a time to discuss with your pediatrician any concerns you might be having with baby care, so that is a good time to write down your feeding questions, write down your skin care questions. Your pediatrician is really going to look at baby’s weight to make sure they are at or near the birth weight. By this period of time they should not continue to be losing weight. They should be feeding okay, whether that is breastfeeding or bottle feeding. Your pediatrician will ask you questions about how frequently they are feeding, how much they are taking, make sure they are not having any problems with feeding. This would be a great time to bring up breastfeeding classes because a lot of pediatricians have access to a lactation consultant or someone who can help you out. And again we do a full exam with baby, make sure that everything looks normal in terms of the head, ears, eyes, nose and throat, we listen to the heart make sure that there are no heart murmurs, we’re listening and checking their lungs, their belly, we check their genitalia and make sure everything looks normal.”

“We check and make sure there is not any sign of hip dislocation or any other thing. And just making sure that in general their neurologic status is normal. So that is really what the 2-week visit entails. There aren’t any vaccines that are done at that period in time, we do get their second (heel prick) screen done at that period of time and the reason there is a repeat of (heel prick) screen done after 2 weeks of life is we want the babies to be feeding for a significant period of time when we recheck the blood because that helps test for one particular illness, a metabolic problem that we can’t detect on the first screen alone. So that blood work is done usually we’ll just take a little bit of blood. But it’s an extremely important check-up.”

If you’re like me, though, the 2-week appointment will not be nearly enough interaction with your doctor. When should you call?

“I always recommend to parents better safe than sorry. Don’t feel guilty about calling your pediatrician when you have questions. It is always important when you come in for visits to write your questions down beforehand. Just keep a little spiral notebook and write those questions down because that way you won’t forget them when you come into the doctor. But if a question comes up after you’ve left the doctors office or in the period of time before your next appointment, call. That’s what we’re there for. We’re there to advise parents and more than happy to discuss with them any of their concerns, but better safe than sorry. You know, in the first month of life, if they have any fever more than 100.4 that is a reason to come immediately to the doctor’s office or the emergency room for an evaluation because that can sometimes be a sign of bacterial infection, but any time parents have a concern that is appropriate to call the pediatrician.”

So there you go. The basics of baby boot camp for your baby. This will be a wonderful, crazy, intense, terrifying and thrilling period in your life as a family. Dr. Sara Rizvi says it’s a time when you can indulge your urge to just adore and cuddle your baby 24 hour a day, 7 days a week without guilt.

“Feed them, love them and give them all of the attention that you want to give them, you won’t spoil them.”

You won’t spoil them, and then in a couple of years they won’t let you touch them, so enjoy this. In those first few months your baby doesn’t need games or toys or school or music class or anything to grow smart, strong and healthy.

They just need you.

We hope you’ve enjoyed this Pea in the Podcast: Caring for Your Newborn. Please visit our website for more information about our experts, to find links and transcripts and to register to get tailored week by week shows for each week and stage of your pregnancy. It’s everything you need to know about your body, your baby and the big changes ahead in your life in your journey to becoming a mommy. For Pea in the Podcast, I’m Bonnie Petrie. Thanks for listening.


Websites I found invaluable when my baby was small were, and I referred to Dr. Sears’ Medicine Cabinet all the time. I hope they are helpful to you, as well!