How to Raise a Healthy Infant – What to know during the first 12 months

hi everyone thank you so much for joining me tonight congratulations my name is dr. Kimberly lank and I'm a pediatrician at home medical grew up in huntin Beach and I'm very excited to talk to you tonight about how to raise a healthy infant want to know what to know in the first 12 months so here's an outline of my presentation of course there's a lot to cover hang on one second okay technical difficulties there we go okay so here's an alignment presentation of course there's gonna be a lot of information because I'm covering 12 months of your baby's life so hopefully it's not too overwhelming and bear with me and we will have or answer any questions at the end so make sure to type in any questions that you have along the way and at the end I'll answer all of your questions so during the hospital stay I'll talk about that talk about well child care nutrition urine and stool sleep routine care safety vaccines and development okay so what happens during the hospital stay so your baby is born congratulations is a very exciting time and there's obviously a lot of emotions and it's just an amazing moment for you what happens right after birth you experience a very special time with your baby it's a called the Golden Hour it's that bonding time between mother and baby and partner and really it's supposed to have very minimal interruption from anyone into including nurses doctors no one's really supposed to be in the room with you or at least interrupting you very much and essentially during that time you have a skin-to-skin moment with the mom and baby where that helps with the respiration rate the heart rate the temperature of your baby and it helps mom with flack tation and then also within that hour you want to start breastfeeding so again it's a very special time and then after that your baby will receive the hepatitis B vaccine the vitamin K injection and erythromycin ointment then throughout the hospital stay you will be seen by a patrician daily and your baby will be weighed and have vitals taken you'll have a lot of support so of course lactation assistance and that's from either your pediatrician the nurses the lactation specialists and there's a few screens that happen before your baby will leave including the bilirubin screen cardiac hearing screen and also the newborn metabolic bloodwork and of course you'll undergo discharge planning before you leave and so in terms of discharge planning you're usually seen within the first two days after discharge so usually two to three days depending on what's going on with your baby and then from there you're seen at two weeks and two months four six nine and twelve and then of course anywhere in between but these are four more well visits and there's a lot that we talk about the well visits we go over a nutrition the urine and stools growth sleep development safety physical exams and of course the immunizations okay so in terms of newborn nutrition I'm sure many of you know breast feeding is the best and we do recommend exclusive breastfeeding for the first six months and there are many many many benefits of breastfeeding but here I've just touched on a few so for the for the infant you'll see a decrease incidence of SIDS diarrhea lower respiratory tract infections ear infections meningitis botulism UTIs it optimizes their development and cognition and of course it improves bonding with mother and then from mother there's a lot of benefits too and again these are not the complete list but these are the main benefits here are our return to pre-pregnancy weight decrease postpartum bleeding reduce risk of ovarian cancer and finding with your baby and of course breastfeeding is economical and readily available so in terms of a few breastfeeding truths this is not always talked about but breastfeeding is not always easy so it may take some time to establish good breastfeeding and know that you are not alone and this is a very very normal your baby's learning you're learning make sure to take advantage of all the help you're gonna have when you're in the hospital and also outside the hospital your Peterson's always there for you to support you you have your nurses while you're in the hospital lactation specialists then also we have the baby line here at Hoag so make sure to write down this number or take a photo and this will obviously be very readily available wherever you look or if you even want to google it and also hoga is offering now a gift certificate for the pacify app which is a year's worth of subscription to 24/7 access to a lactation specialist so that's really excellent so in terms of breastfeeding as I already mentioned you want to initiate this as soon as possible that will help with obviously establishing good breastfeeding and then for mother to produce breast milk you want a nurse on demand when there's signs of hunger so sides of hunger include increased alertness routine mouthing it's really important to know that crying is a late sign of hunger so despite what people will tell you you don't want to wait to your baby's fussy that's a late sign and that will make it even harder for you to establish a good latch and a good routine if you're waiting until they're crying so make sure you look for early signs you want to feed them usually around 8 to 12 times in 24 hours but it could be more it just basically it's based off of your baby's cues so make sure just to pay attention to their cues and you'll you'll get the hang of it like I said you learn from each other and usually it's about 10 to 15 times per breast and you don't want them to go more than four hours in the beginning without feeding so in terms of breast milk and the in the very beginning you'll have your first few meals of breast milk include oops sorry the first meals will be colostrum and that is a different substance that you it's not doesn't look like milk really in the beginning so it's like a kind of a sticky a yellow substance but it's liquid gold has so much nutrients in there for your baby it's all your baby needs in the beginning and it's high in protein and vitamins and the minerals and MU logic components like antibodies and it's a little bit lower in the carbohydrates and fats and then you'll start noticing your milk coming in and that's usually around day three or five of postpartum and from there you'll start noticing that the color will look more like than the milk that you're used to like a creamy color that's higher in fats and carbohydrates lower in protein and it also includes antibodies as well and at that point you're going to notice that your breasts start to feel full so you don't know when your milks starting to come in and an important concept is supply and demand so this is not often taught in the very beginning but I want to teach you now so you know so the more you put your baby to your breast the more you do skin-to-skin the more you're going to produce that milk so obviously there are some scenarios you're gonna have to introduce a bottle or formula and that's totally okay of course we try not to do that at beginning but sometimes you have to but if you are doing that make sure you're keeping up with either pumping usually what you'll need to do if you're doing that instead or more skin to skin your body won't know that you need that extra breast milk if you're interfering with other means of feeding and often mothers are worried in the beginning that they may not have enough milk and especially with the colostrum because it seems like it's so little but like I said it's liquid gold is very powerful and your baby's stomach is very very small in the beginning so you can see here the first couple days of life the baby stomach is the size of a cherry and then from there it increases so walnut size apricot size so what you're producing is enough and it's important to stay hydrated and try to be you know stay relaxed and take care of yourself and you will produce enough for your baby so in terms of storing your breast milk the easiest way is by rule the rule of fours so four hours at room temperature and four days in the refrigerator and then from there you can freeze it in a normal freezer for up to nine months and then in a deep freezer for twelve months and it's important that once your milk is thawed you need to use it within 24 hours and once your baby takes any taste of that milk so it whenever it touches your baby's lips you need to use it within two hours and as I already mentioned breastfeeding is the best within the first six months but of course if you do want to do formula feeding but you don't need to nothing else is the point of that first bullet so no no water no juices nothing else that's what you need in the first six months and then ideally if you can continue breastfeeding for the first 12 months that is the best for your baby and we do start solids around 6 months usually we'll talk about that more later and that's when you can introduce water and again feeding on-demand every 2 to 3 hours no more than 4 hours in the beginning 15 minutes per breast and it comes out to about 2 to 3 ounces per feed or about an ounce an hour and by the end of the first month you can get up you usually have to run 4 ounces per feed and then by 6 months it gets to be around 6 ounces per feed max 7 to 8 ounces with 4 to 5 feedings per day and you also want to offer vitamin D supplementation and I'll talk about that a little bit later okay in terms of formula there's a lot of different formulas out there it's easy to get overwhelmed with all the options but generally if you're gonna do formula your pediatrician will usually recommend Enfamil or a Similac those are the formulas that are most similar to breast milk and they've been studied the most and there's so many different additives to some of these that you just don't need and some of them just become very expensive and the very specialized ones are generally saved for certain medical problems so I would obviously already be talking to your patrician about doing any of those specialized formulas so in terms of vitamin D supplementation you are going to want to supplement your baby with vitamin D if they're exclusively breastfed or even if there's formula fed because you need at least 33 ounces of the formula to get enough vitamin D per day so I generally recommend vitamin D across-the-board especially in the beginning and in for breastfed infants the exclusively breastfed up to actually we recommend it until 12 months so it's 400 international units per day and you can get this really anywhere and these are the ones at the bottom that I usually recommend but I really like the D drops because it's one drop we can put on your finger you can put on your nipple and that's it so you don't need to do like a larger liquid and vitamin D is important for tooth formation and bone formation regulating calcium and it's generally found and fortified dairy products fish oils margarine egg egg yolks and sunlight and these are all the things that your baby will not be getting in the first 12 months of life so that's why I do recommend it and that's why aap recommends it and almost every pediatrician I know of course will recommend it and so for spit-up so this is something that it's important that to know that every baby has some level of reflux so almost every baby will spit up in some way or have reflux going on and that's mainly because the flap over the stomach is not strong enough and so it you have this reflux happening sometimes it comes out sometimes it doesn't it's usually not a concern this is different from vomiting for sure and it rarely causes any weight loss discomfort or choking and vomiting is very different you'll you'll know the difference eventually but like when you obviously see in your baby but it's more forceful and it causes discomfort it's but it's usually kind of dribble out of the side and it's a it looks it may be concerning cuz it may be a lot but usually it shouldn't cause any problem at all and ways to help this include you wanted to decrease any interruptions sudden noises or bright lights when you're feeding because any startling that might cause more reflux you want to burp often so usually after you feed getting a good burp in that's sufficient but if you're starting to nose more spit ups then you might want to burp in between breasts or even every 3 to 5 minutes and then also holding your baby upright for 20 to 30 minutes after feeding which is actually a very long time that's really good for reflux prevention too and if all these things aren't working you're probably going to be talking to your patron anyways but smaller more frequent feeds are recommended so in terms of solids as I've already talked about I usually don't recommend solids until six months but anywhere from four to six months could be okay but six months is a really ideal because you want to wait till they are developmentally ready so in terms of that you want to look for good head control good chunk control sitting up and an interest in solid foods and if they're not showing you these things and you don't really want to start yet and that's usually run six months is when they are developmentally ready and also interesting too early can lead to things like iron deficiency anemia obesity so we usually always recommend around six months if they initially refused solid foods don't force it don't get worried just try again in a week or two of course if you're nervous about it if they're never you know accepting the solids and you might want talk to your pediatrician but usually they come around to it in the beginning it's very much a they're practicing they might just see them kind of you know push it out and they're not really swallowing it sometimes they might just push it and then they eventually will swallow it it just takes time and they've been used to one thing their whole life up into that point so so again just try it again a couple weeks if your baby's not really happy about it and and it's important to know that in the first 12 months sorry yeah first 12 months the main source of your baby's calories should come from the breast milk or the formula so even when you introduce solids the the bulk of the calories should be from your breast milk or formula and then you transition around 12 months so the solids are really more of a practice in the beginning and so for solids you want to introduce a variety of foods especially the allergenic foods so your shellfish your nuts peanuts eggs those are very important to do in the very beginning all the studies are showing that that's a lot more beneficial and decrease the rate of food allergies and and then also it's important to know if your baby he doesn't like some of these things or doesn't like a specific type of solid it doesn't actually mean they don't like it that you have to try at least 15 times to determine if they're gonna like it or not and then you also want to make sure you avoiding these are choking hazard of course so grapes hard round foods hotdogs nuts are listed there but if you give it to them in a way that they can handle it so you blend it up puree it up and that could be okay and the the real rules of six of twelve months so the other besides the choking hazards is you really don't we do not recommend any honey until twelve months and up and also cow's milk and that's mainly cow's milk that's replacing any of your breast milk or formula you can give dairy products so cheese's things like that yogurts but you don't know what that to be replacing the the breast milk or the formula that they're getting and so as I mentioned earlier you can introduce wall water once you start solid foods but you don't want to do any juice usually we usually don't recommend juice in general but but less than one year of age for sure we don't recommend that it doesn't really give you any sort of nutritional benefit and they can also cause those stools and around eight months they do your baby starts to learn how to finger or they want to eat so offer finger foods they start trying to feed themselves so at that point they should be really City independently and offer them a spoon too so some of the finger foods include steamed veggies banana as well cooked pasta small pieces of bread things like that scrambled eggs and then by nine months you want to transition to three meals and two snacks okay and then around 12 months as I mentioned that's when you switch so the diet at that point should consist of mostly solid foods and now the you start whole milk cows milk and that's a supplement so 16 to 24 ounces per day at that point and you also want to wean off the bottle okay so now we're going to talk about elimination so this is going back to the beginning so in terms of urine and and your baby they need to have essentially a urine per day of life so day of life one one year in daily life two to urines and so forth up until day five and then it's around five to eight and four stools this is much different so the amount of stools can arrange a lot during the first few days you'll notice that the stool is going to be a thick meconium that's black and it's sticky and that later transitions to more of a brown Yeller Yeller yellow looser stool with a little CD in this to it especially if you're breastfeeding and as I mentioned there's a large range of how many stools babies have per day some babies have multiple per day some of every feed and some have less than one per day and that's actually totally fine they can skip days and not have a poop as long as everything else is fine they're gaining weight they're eating fine they're not vomiting things like that the problems that we do have those stools or the things that we do want to know about our hard pebbly stools we don't like white stools black stools or red stools so if any of those things are happening definitely let your pages should know okay so for sleep so then your newborn is going to sleep a lot in terms of the hours per day so 16 to 20 or 18 hours per day is the amount of sleep your baby's in the being so it's a lot and they generally do wake though every two to three hours to feed and they're usually more active at night than during the day and that transitions around two months where they start becoming more alert and awake during the day so that's a fun milestone to look forward to we don't expect any more than the six hours straight though until four months so you they're generally not development ly ready to sleep more than six hours straight at that time so that's also why we don't recommend a sore sleep training before four months of age they really can't self soothe very well until then so it's it's we as patrons we usually don't recommend doing any sort of sleep training until then and then by four to six months they usually have about three naps per day and then six to twelve months two to three naps per day about six to ten hour stretches at night so that's exciting and so for sleep you do want to start doing a consistent bedtime routine when it makes sense for you so this is not really sleep training it's more of just developing good habits giving your baby a warm bath they're walking reading so they kind of know it's time for bed and you want to put them in their crib before they actually fall asleep so you don't want to wait until they are asleep in your arms and then put them in you want to transition them in when they're drowsy if you don't do that they they can wake up and they get startled that they're no longer in your arms so this is the best way to go about it and then for safe sleep this is very important so you want always always put your baby on their back and they need to be in a crib or bassinet and in parents room until twelve months is the safest you want to use a bassinet or crib that has a firm mattress with a fitted sheet and you want nothing else in there and no no pillows no bumpers no toys no blankets nothing else anyone to make sure that the temperature in their room it's comfortable and you don't want to overdress them or over wrap them and you want to make sure no one smokes around the baby and all these things helps decrease the risk of SIDS and then in terms of routine care so you want to keep the your your baby's umbilical cord you want to keep that dry and so you basically don't want to touch it really you want to keep the diaper below it you don't want to do any sort of submerge in baths but you can do some sponge baths and then the stump usually falls off around one week of life the things to look for our spouse smells redness or a lot of large discharge those are things you definitely want to tell your pediatrician about and as I mentioned you wanna do sponge baths until that stump falls off and also if your baby's a boy if he had a circumcision you want to wait to do a full submersion bath until that circumcision is healed as well and I we always recommend usually bathing with fragrance free soaps it's okay to use fragrancy lotions as well like Vaseline if needed but it's not always needed you want to avoid direct sunlight we don't recommend any sunscreen until six months of life but of course if you are in a scenario for some reason that you can't avoid direct sunlight then that's something that you could potentially do but I would talk to your pediatrician first about what they would recommend usually around six months is when sunscreens most safe for your baby and of course right now it's obviously different but in general we always avoid avoiding or recommend avoiding sick people and crowded public places but I know we're not doing that right now anyways and in terms of dressing your baby as I mentioned this light before whatever you're comfortable in your baby should be two plus one one more layer like their swaddle that should be fine you want to call your pediatrician if there's any fever so a fever is greater than one hundred point four and of course any poor feeding change and wet diapers or any concerns that you have so for safety so more safety elements you want your baby to be in a car seat and they're in the back of your car in the back seat rear-facing and again smoke-free environment and you want to avoid drinking any hot liquids around your baby while you're holding them and you want to set your home water temperature to be less than 120 degrees Fahrenheit you want to keep your baby or your hand on your baby while you're changing them and keep any bracelet strings or cords away from them you want to leave them alone the tub of course and the concept of cocooning so you want your infant to be well when you can see more people you do want your infant to be surrounded by those that are vaccinated so again once things you know change once you're seeing more people or visiting you want people caregivers and visitors to be up-to-date on Tdap especially in flu and we'll talk about the Tdap a little bit later so for childproofing you want to start working on these things just to get things ready you want to keep heavy objects HUF and hot liquids off tablecloths you want to look into getting a gate for stairs if you have stairs you need barriers around space heaters and locks on windows or guard street screens do not count for this that's out of guard so you need to have a walk lock or some other safety mechanism for your window keep cords out of reach and you want to keep your baby and arm to reach whenever you're near water and then you want to store clean or the cleaning products medication anything that's unsafe you want to be high out of reach and poison control it's really important to have this number so I would save this number put in your phone right now so you have it just in case okay so for immunizations so at Hoag medical group and pediatricians generally across the board we definitely recommend vaccines is a very important part of your child's health and safety they are safe and they're effective and here's a general overview of what to expect during the 12 first 12 months in terms of vaccines so it may seem like a lot but it's really not too much a lot of them are combined and they're very safe and as I said effective and they're definitely recommended and then you'll see at 6 months we do recommend the flu vaccine and that's a very exciting time it was for me when when my baby was was able to receive the flu vaccine and so I'm gonna go into a couple of these vaccines that you may not be as clear about so I'm gonna talk a little bit about the DTaP vaccine or Tdap like I mentioned earlier so this is the vaccine that we that is to protect you against the P part is the important part for the well it's all important but the P is the pertussis the whooping cough and that's a highly contagious respiratory disease and that's caused by bacteria it can be fatal in infants less than one year and infants are often affected or infected by their caregivers and by other children around them older children and because the whooping cough can actually present in older individuals as just a respiratory or you're like a URI are cold so it may not be as obvious that they have the whooping cough so infants will generally develop sometimes about five to ten days after exposure and so you want to make sure as I have already mentioned that the caregivers or visitors are up-to-date on their vaccines including the Tdap vaccine so in in terms of symptoms this causes violent coughing difficulty breathing apnea which is basically your baby stops breathing and this usually happens in infants and complications include hospitalization apnea and there are some there are deaths of course from this illness so outbreak so in 2012 the u.s. saw about 50,000 cases of pertussis with 16 infant deaths and in 2019 the u.s. reported 15,000 cases and three infant deaths and most infants are many infants are hospitalized with this infection and the peak incidence occurs every about three to five years or so and prevention again Tdap vaccine pregnant women will receive the Tdap booster during their each pregnancy around the 27th to 36 week and although caregivers should look into getting the Tdap booster it's generally very easy to obtain and you want to make sure your other other children are up-to-date and that your infant can receive the vaccine as early as six weeks so here's some other important important information and just some pictures that show the effectiveness of the vaccine and also that this that whooping cough or pertussis is really very prevalent in infants so you can see that the the yellow or on the my left side the the graph that shows that pink line at the top that shows how prevalent it is in infants and then you'll see at the next graph you'll see the yellow line that shows effective the vaccine is at decreasing the amount of cases of pertussis and then the bottom table just again stresses that this generally occurs really affects infants and it can lead to some devastating consequences so the next vaccine or infection I'm gonna talk about is that caused by the bacteria I'm off less influenza hip this is a bacteria that causes severe infections in children under five it can cause pneumonia meningitis epiglottitis which is an infection of a throat and it causes very difficulty breathing bloodstream infections ear infections so three six percent of infants with him meningitis died and twenty percent who survived have permanent hearing loss or other neurologic problems and the United States started using the hip vaccine for children in 1987 and for infants in 1990 and then we saw the annual incidence of invasive hip decreased by 99 percent with this vaccine so before the vaccine there about 20,000 cases per year with a thousand deaths and children under five and then by 2007 the incidence of invasive hip disease and children was around 0.18 cases per 100,000 and generally the cases occurred in children that were either too young to receive the vaccine or children that weren't immunized so strep pneumo that's another cause of severe bacterial pneumonia can also cause meningitis ear infection science infections bloodstream infections the higher risks are high risk children are less than two years old and those that attend daycare or group childcare so one in 10 children under five with pneumococcal meningitis died others have hearing loss developmental delays so again it's vaccine preventable with Prevnar 13 and since the vaccination was introduced the rates decreased by 99% so here's another graph just depicting the effectiveness of the vaccine eat and just see how their rates just plummet after the vaccine has been introduced okay so development so in terms of some milestones that s patricians look for in the first month you'll see that your baby will recognize parents voice they lift their head when they're on their tummy they follow their parents with their eyes and around two months they start smiling and start cooing they have better head control at that time you'll start seeing well they should always be moving their arms and legs symmetrically and then they also start to self-soothe at that time but they don't really achieve that until around four months so four months a list they elicit social interactions they start babbling expressively laughing they can push too on their chest and elbows they have good head control and they begin to to roll and reach for objects and again they can self soothe at that time and six months they become more socially interactive with parents they recognize this they recognize familiar faces they definitely roll very well but that point they sit with support they explore their environment by putting everything in their mouth and they stand with assistance they like to balance and at nine months you start seeing the stranger anxiety they start to seek out their parent they use repetitive sounds and they point out objects learn interactive games explore their environment they should be crawling it by that point they pulled a stand they cruise they say mom and dad but it's not specific so it's just mama dada and they wave bye-bye and at 12 months you start seeing that they imitate your activity they form a very strong attachment with their parent they speak 1 to 2 words and that's specifically mama dada they can stand take a few steps on their own you just about 1 to 2 and they can follow simple directions so tummy time how many times very very important it really helps with a lot of things so the gross motor skills it helps with increasing the neck back and arm muscle strength and it improves head control and this decreases the risk of SIDS and it also helps with head shape and you want to start this once the umbilical stump has fallen off so that you don't irritate the skin around it and you want to perform it try to perform either before feeding or 30 minutes after feeding while awake on a safe firm surface under supervision so this is hard to fit in especially in the beginning because if you're trying to do it either before feed they're usually you know they're hungry and then performing after about 30 to 40 minutes after couple 30 minutes or so after because you don't let them spit up so you're gonna find that it's kind of difficult to fit in but just try any time that you can and whenever it seems right fitted in it's better to get smaller bursts of this route the day then to have one long tummy time period or experience and the goal is to eventually though so you'll start noticing it will get easier and easier to fit it in its eventually you want to have your baby to be and tell me time about 50% of their awake time and tubbing time so that's a lot of time okay and then in terms of infant needs for development they then need to feel loved and special and valued and safe they want to feel confident about what to expect from their environment they you want to expose them though to different languages play exploration books music and toys and during the first three years of your life or their life their brain has the greatest potential for learning and then the first 1 2 3 months you want to provide a consistent warm environment with physical contact and a lot of talking and reading singing you want to dress them by their name you want to be able to you want to read their cues know when they're happy versus upset and you want to respond to those cues you can't spoil a baby and that's in the first three months of their life and you want to provide colorful objects of different sizes shapes and textures so from four to seven months you want to provide a safe environment so that's when your babies start to do a little bit more to explore and roam freely you want to talk to them again read seeing you want to help your baby my imitate your set their imitate sounds and it's fun to imitate back to them as well you want to read every day and show interest in the sounds that they're making engage and with of movement dancing eventually introducing them to other children and parents and you want to avoid any stressful or traumatic experience and so from eight to twelve months you want to encourage play with blocks and soft toys and want to play games like patty cake and peekaboo and you want to teach them and say bye-bye shake their head yes or no and you want to spend lots and lots of time on the floor and that is about it I know it's a lot of information thank you so much for listening and now hmm we have questions okay so I'll be answering any questions now that as they come my way so that's the slide that I talked about so I can probably scroll back but I also know the answer off the top of my head of course but let me get to the slides so that you can have it in front of you oh there okay so so for SIDS so you want to put your the baby on their back you want to have a firm mattress with a fitted sheet you want nothing else in the crib at all so no bumpers no stuffed animals no extra blankets you don't want any extra blankets I know toys and keeping them in your room with you up until six months is the minimum but if you can twelve months is really ideal and then a smoke for your environment of course you want to make the temperature comfortable don't over address them and those are really the key elements to to preventing SIDS and breastfeeding as you mentioned so when their so okay so for breastfeeding so about 15 minutes per breast is what you usually a.m. for 10 to 15 minutes per breast okay so hmm Oh repeating the question yes sorry so how do you know when your baby's full and can you overfeed your baby and how do you know if they're getting enough that's like a multiple part question so they'll pull away generally when they're full and they'll be satisfied so they won't be looking for it anymore and they they'll go to sleep or they'll feel a lot more comfortable they can be overfed though so if you overdo it in terms of if if you feed every time that they stir or get upset you can ever feed which is actually surprising for a lot of people so make sure you go through like I said in the very beginning the beginning you want there's a lot of different things that can cause crying so they might need to be talked to saying to move picked up walked around burped changed it's not always feeding but there is what's called cluster feeding sometimes the beginning where if they're showing you all the signs like the routine the mouthing like like sticking their tongue out then then they probably are hungry and there can't that you can feed sometimes every hour and it could be totally normal I think I answered all the questions there okay so that's another well Enfamil Similac are the ones that we need to recommend the the one that's pre-made is very convenient but I find that economically the powdered ones and the via can you get more out of it so we usually recommend Enfamil or Similac just because those are study the most and they're most similar to breast milk and those are very easy to find anywhere so by and large 99% of people that we have come into our offices they don't have vitamin D started yet but we don't see your baby until day like two or three and it's totally fine if you haven't started it yet we I do hope Medical Group we often have some samples that we give out at that point and parents are very grateful about that some parents do have they have already bought in it and that's great too but it's okay to not start it day one if you know you're taking everything else in and you're kind of just getting the swing of things but your pediatrician will talk about it when they see you for the first time okay so in terms of are we at repeating the questions I'm sorry so ideal temperature for your baby is around 70 degrees so when they're sleeping sometimes 68-69 around that basically what you're comfortable in and same with the car you don't want to you know blast the air too much you don't want to have the heat going like crazy and let's you know you just want if you're comfortable that your baby's comfortable obviously never leave them in the car on their own and and then usually in terms of being in the car we do recommend it social in the beginning if you're going for long drives to take a lot of breaks so you don't have to it's especially here or in most places as long as you keep the temperature in your room and there oh I didn't repeat the question can you wrap your baby in a fleece blanket at night I'm sorry and so generally you don't have to wrap your baby in a fleece blanket at night as long as the room is comfortable whatever you're comfortable in your baby should be comfortable in so they can wear a onesie and just one wrap or one swaddle and that is totally fine and around two months I don't think I mentioned this but two months is when I recommend stopping the swaddle because you could have a range of time where they start to to roll and so around two months they might start to roll so we usually discontinue the swaddle around that time okay is this new bassinet stay comfortable for newborns so the question is about the snoo so this there's a lot of debate on that and there's a lot of different opinions in terms of pediatricians and what they recommend for thus new some love it and some really don't like it for me personally I know that this new can offer a lot of benefits but they're strapped down usually in that and I don't personally feel comfortable with that knowing that weird things happen and if your baby flips over somehow they really really cannot get back so but again there's a huge range of opinions on the snoo so the question is if your baby spits up should you replace the amount of milk that they've spit up usually no often that spit spit ups can can be assigned to of overfeeding sometimes not always but sometimes so no and it's hard to know how much they've actually spit up too if they seem hungry then you know if they're still showing you cues or mouthing their routine then you can try to continue feeding but usually you don't have to think about replacing that food and giving back no sorry the question is the question is how do you feel about a head shaping pillows absolutely not no pillows at all in the crib or the bassinet so the question is what age can we introduce a stuffed animal slash blanket and that is after twelve months receive at the hospital again and which vaccines are given while pregnant so the question is which vaccines are given at the hospital and which ones are given to pregnant women so the baby will receive the hepatitis B vaccine and then your during pregnancy you'll receive the Tdap and the flu vaccine so the question is at what age are babies or is it safe to introduce your babies to new people so right now it's obviously a very different time so I would have a different answer usually about with this but by and large 30 days at home is really recommended in terms of the first month is you want to try to limit exposure as much as you can and obviously especially right now I would not recommend any visitors right now but you know obviously you have grandparents and things like that that are going to want to visit and see your child so the the less amount interaction the better right now but for sure in the 30 the first 30 days that's when your baby's most at risk for infections that can spread to their brain so that's the time that you really want to be really strict and then and then the first two months there obviously are still risk factors but there's a lot of benefits to to introducing your child to other people but it's right now it's hard to really answer that question too because it's different so just be careful with your visitors and you want to limit any any visit visiting right now especially with the restrictions and guidelines so the question is our pacifiers helpful and if so when should they be introduced I'm gonna take a little sip of water real quick so I really like pacifiers but you want to wait until a good breastfeeding has been established and that's usually around 2 weeks and then you can start using the passive so as long as you really have a good rhythm going with your baby you're doing your breast feeding really well then you can introduce the pacifier and that actually it's another thing that helps to decrease the risk of SIDS so I'm a fan of them so you want to make sure that you're the good the question is what temperature should you be bathing your baby at so again a comfortable temperature so you want to put your hand in the water I generally recommend that rather than relying on any thermometers or things like that as long as it is a comfortable temperature for you not too hot not too cold that will be the temperature that you're going to want to be their baby in so the question is how soon can you take your baby for a stroller walk so again right now it's a little stricter in terms of the recommendations for that but walks are good getting out getting some fresh air moving around especially for mom too so you can do it pretty early but you want to just try to do it at times that you may not have much interaction with people but you I always do recommend it's just in the beginning to to cover your baby for sure because of the first for one thing the sunlight and you'll be surprised even right now how people will reach in and touch your baby I have a 8 month old and I just was on a walk the other day and someone reached in and just grabbed him and you know so these things happen I also had someone even my baby was covered in the car seat they pulled down the cover and looked in and tried to throw in a toy so some things happen so but usually do you have the cover around that's kind of a sign for people to to you know to maybe not touch them but right now again go at times meet with it you won't run into that many people it is good for you to walk good to get some fresh air and and of course you don't want to get your baby direct sunlight for more than 15 minutes at a time or even all if you can avoid it the question is what angle are they supposed to lay in their stroller so it depends on what kind of stroller you have a lot of people end up having a car seat that clicks into the stroller and it's the incline it's hard to say like the actual degree but you don't want them to be too vertical because then their head will fall down so and that will cut off the airway so you want it to be at a kind of like a angle like this to where they're comfortable they're laying back they're not going to have their head fall forward and they collapse the or they block their airway so the question is can we have our baby sleep with sleepless eyes sleep with us in the bed teachers do not recommend co-sleeping it's dangerous so that's something that you'll probably see across the board that will say no it's not recommended and it can increase suffocation and SIDS as well so the question is should we place our baby on their side to avoid throwing up and the question the answer is also no still always recommend put your baby on their back parents do worry that they're gonna spit up and choke but that hardly ever ever happens it's very very very very rare the amount of babies that have SIDS it's higher than that so the risks of putting them on their side is a lot higher than putting them on their back so always always back so the question is when is it safe for air travel so that's a of course not right now but when things change I always recommend waiting longer the better I charge it depends on also the season that you're traveling winter time is not a good time you're stuck in air with a bunch of people and a lot of different germs has as well know you want to try to wait until at least the first set of vaccines ideally as the more vaccines the better especially you can get the flu vaccine that is the safest but I know life happens sometimes you absolutely have to travel and so I would just discuss it with your patrician first to see if it's safe at the time that you decide to go the question is are humidifiers safe to use or they are they recommended we do recommend them for certain scenarios so if your baby is congested so that's something that you can have in the room you'll have to have it though it's not something that we would recommend outside of congestion like you don't want to you don't have to use it for prevention but it's definitely definitely safe okay so the question is at what age do you recommend starting to childproof so as a mother and pediatrician my baby is eight months and the sooner the better of course but there's a lot going on in the beginning to where you are going through a big life change and it's amazing but some of those things can obviously wait so just try to tackle one thing at a time but for sure once your baby starts any showing any signs of mobility you definitely want to have avoided waiting too long so you don't want to wait until they're crawling to start chop roofing so enrolling too they get around a lot actually when they roll so rolling can happen anywhere from three months maybe even sometimes two it's that's pretty early but usually they're on four to six months so you want to start trying to childproof around that time are a little bit before if you can the question is is pest control safe to do to prevent any sort of like fleas and ticks and etcetera so I guess it depends on what type or what they're gonna do I know that there was a moment where I needed to get a I wanted to get my house fumigated because there was ants but all of the the companies recommended leaving the house for like an extended period of time and also emptying out all of your cabinets and kitchen and closets and so it just it seemed like a very big task and so I never did it but I would just talk to the company that's doing it and make sure it's safe but they usually make you leave the house for quite a while obviously if you do it before they're born it should be fine so the question is hang on I'm sorry so the question is about Co vyd and the new any of new recommendations in terms of exposing your baby to some other people and grandparents daycares so as I've already kind of mentioned that in the first few months of life that already is a precious time and a time that they are susceptible to a lot of infections right now it's not recommended obviously to have they recommend seeing at home staying separate and daycares are opening up in a couple weeks for a lot of places but I wouldn't start obviously they care until obviously the you're gonna be home anyways so waiting until you go back to work and starting daycare ideally once you have your first set of vaccines is safest obviously kovetz different we don't have those things and it's really hard to give really clear guidelines for that right now - just because it's changing every day right now the nice part is that by and large children are not as affected but infants don't have as strong of a mewn system and they can have devastating consequences from an infection in general any infection can be really bad for an infant so try your best to just stay secluded as long as you know those are the guidelines recommended for obviously right now that's how it is record or that is recommended and you want to protect your you know the grandparents too so you're obviously going to be the hospital when you have them so that's going to be an exposure so there's so many layers to it it's a hard time right now but just you know try to if you're try your best to be patient and enjoy the process and it changes everyday so it's also like I said it's hard for me to really know what's going to happen in the next few weeks but right now just plan on having a very limited exposure so the question is what are your thoughts on having a bassinet or crib near a liken vent air conditioning so you just want to make sure that they're comfortable and where they're at so before your baby comes if you want to kind of sit in that area and see how it feels but it's good to have a thermometer or gauge on what the temperature is in the room but I don't need necessarily you definitely don't need anything blowing right directly at your child again whatever you're comfortable with is what they should be comfortable with in Huntington Beach often there is not a lot of houses don't have AC and that's what I have if I don't have AC in my home so if your baby is born in the summertime you are worried about the their room being too warm but they will be next to you so that's another thing too they're gonna be you're gonna be in a room with the bassinet nearby and so you're gonna know if you're not comfortable if you're warm you may have to put in some fans too to bring down the temperature essential oils safe to use for pregnant women and babies so the question is our essential oils safe to use in pregnant women or and/or in babies I would ask your OBGYN about that in terms of for pregnant women for babies we don't recommend it again in the first six months they can absorb a lot through their skin their skin really absorbs a lot so we don't recommend anything like that so the question is can you offer any advice on interaction with pets as someone who has two pets at home I have two basset hounds so I know how important they are to your family and they are like a member of your family so in general you want to make sure that you're always around of course when you have the animal in the area with your newborn however if that animal had any signs earlier on of aggression then you know that's common sense that you may not want to have that interaction but you always want to be around with an arm's distance making sure that you know when your baby starts grabbing for things showing interest in your pet you want to be right there even pets that show no signs of snapping or aggression can sometimes react that way if their ears are being pulled or their eyes are being poked so you won't always be there and make sure that your animal is also following guy vet guidelines you want to make sure that your animal is up to date on their vaccines that they're healthy that's always important too and then and then obviously you want them to just be taken care of and and oh and I was gonna say another thing some things you can try are before you introduce the the dog the cat mainly with dogs is why I mean I know more because that's my BOB my but we have top dogs but bringing home like a blanket or a one that your baby has already been in or hat and having them smell that prior to meeting them sometimes that eases the transition too so those are kind of the main things that I recommend so the question is what are my thoughts on the baby wise sleeping method so we do like baby wise but I again I don't recommend any sort of sleep training until four months and then from that point on once you start you start doing a schedule or training by and large the most important thing is that you're consistent so whatever method you choose there's a lot of methods out there but just be consistent with whatever you do and you'll see results on those last questions so anyways thank you so much again for joining me tonight I hope you learned something and and I hope you all stay safe and thank you again and I hope you all take care bye

Channel: Hoag Health

Views: 114,681

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Id: Zu07ByPunE4

Length: 59min 11sec (3551 seconds)

Published: Tue May 12 2020