Newborn Hospital Discharge Information
Congratulations on the birth of your new baby! This page describes some important items about newborns with which we would like you to be familiar. Please feel free to ask us any questions you may have about these items or any other concerns.
1. Feeding: Newborns tend to feed every one to four hours. It is very difficult to schedule your baby's feedings the first few weeks of life, and so "demand" feeding is the rule. Babies sleeping for more than four hours at a time should be awakened for a feeding since they do not have the ability to store energy for longer periods of time. There is usually no need to do this once an infant is more than two months old.
2. Elimination: Most newborns urinate at least five times and have one to ten bowel movements in a 24 hour period. If your infant's elimination patterns do not fall within this range in the first few days of life, you should phone our office.
3. Umbilical Cord Care: The umbilical stump usually falls off at approximately two weeks of age (but a few days or four weeks can be normal). Until the stump has fallen off, it is recommended that you avoid bathing the baby by immersing in a bath; sponge-bathe instead with a gentle washcloth and warm water. Also, each time you change your baby's diaper, clean around the stump with an alcohol-soaked cotton ball or pad. The umbilical area may ooze a small amount of blood when it separates. This is not of concern unless it persists or is excessive.
4. Jaundice: Jaundice, a yellowish discoloration of the skin, is very common in the newborn period. It will usually begin within the first few days of life but may start in the second week or later. If you notice that your baby's skin appears yellow or orange, please call our office.
5. Sleep position: In October, 1996, and again in October, 2005, the American Academy of Pediatrics (AAP) issued a recommendation that infants be placed to sleep on their backs as a measure to help prevent Sudden Infant Death Syndrome (SIDS). Since 1992 when prone (on the stomach) sleeping started to decrease, the rate of SIDS in the U.S. has decreased by 50%. The back position has the lowest risk and is preferred. For more information, an excellent resource is http://www.nichd.nih.gov/sids/
6. Hepatitis B immunization: The Centers for Disease Control as well as the AAP recommend all newborns receive their first Hepatitis B vaccination in the hospital prior to discharge. You should have received a Hepatitis B immunization information sheet and consent form from the hospital. Please read this, fill out the consent form, and return it to the hospital nurses so that your child can receive this important vaccine. Feel free to discuss any concerns you may have with one of us when we round.We are unable to space out vaccinations or use specific brands. There are absolutely no data that support any benefit to children of doing this, and this office policy is consistent with the policies of the American Academy of Pediatrics and the Centers for Disease Control and Prevention. We will treat your child with no less care than our own children or any of the thousands of children whose parents have entrusted us to help care for them at Patriot Pediatrics. It is also an office policy that if families are not comfortable immunizing their children according to the guidelines of the American Academy of Pediatrics, that since our office feels so strongly that this is the wrong decision, it would be better for the family to seek pediatric care at a different pediatric office. If this is the case, we would be happy to transfer your child's records to another pediatrician of your choosing.
7. Circumcision care: For male infants who are circumcised, your obstetrician or Mohel should give you instructions on caring for the circumcision site. These instructions are meant to supplement but not replace them. If you notice bleeding from the site which does not stop with some pressure using the sterile, dry gauze given to you in the hospital, please call our office right away. If you notice a whitish yellow or light green substance which is adherent to the circumcision site, do not remove it; it is part of the healing process. To wash the genital area, simply squeeze warm water from a wash cloth over the area and let it run off. Once the area is fully healed (up to 5-7 days), you may wash this area just as you do the rest of your son's body. During the first 5-7 days, keep the area especially clean and apply some petroleum jelly to the diaper or circumcision site during each diaper change. If you notice any pus, foul odor, expanding redness or swelling of the site, please call our office.
8. Followup appointment: When you get home from the hospital, please call our office to schedule your baby's first check up with the primary care pediatrician.
9. Fever: Your newborn's temperature was monitored closely while in the hospital. While it is not necessary to routinely check this at home, you should check a rectal temperature if your infant feels warm. Call our office right away if the rectal tem-perature is > 100.4 when your baby is under 8 weeks of age since fevers in this age group need careful evaluation. Call us at any time, regardless of the temperature, if the baby is not acting right or if you are worried.
10. As soon as is possible: please notify your health insurance company and your employer so that your baby can be added to your policy. This is very important and must be done within 30 days after birth so that your insurance company does not reject any bills for health care provided.
11. Recommended Reference list:
What to Expect the First Year, Eisenberg et al, Workman Pub. 1989, rev. 2003
AAP Caring for Your Baby and Young Child, Birth to Age 5, Shelov, ed., Bantam, 1991, rev. 2009