New Baby Manual

From poop to pacifiers, the 10 most common concerns.

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As a new parent, you will get advice on everything from how to get your baby to sleep through the night to when she needs her first pair of shoes. It might not all be constructive counsel, however. "There is so much information out there, so many people telling parents about the right and wrong ways to do everything, but in most cases, if parents just trust their instincts, things are fine," says David S. Geller, M.D., a pediatrician in Bedford, Mass., and a clinical professor of medicine at Harvard Medical School.

"When it comes to raising a healthy infant," he adds, "there is a little that's very right and a little that is completely wrong, but most of what we need to do is somewhere in between." That said, here are answers to some of the questions new parents most often ask.

My baby cries a lot. Could it be colic? Colic has no definitive cause and is diagnosed when everything else is ruled out, Geller says. It is defined as repeated crying bouts that last for about three hours, for at least three days in a row, in a healthy, well-fed baby. The episodes can begin as early as age 3 weeks and usually end by 3 or 4 months. "Colicky babies often start crying at around 5 or 6 p.m., but they also can cry at any time," Geller says. Colic may be the result of an immature intestinal system, a way some babies relieve stress or just a normal phase some infants go through, he adds. For tips on soothing, read on. How can I comfort my crying newborn? Or should I just let her cry? At this age, there is no reason to let your baby cry for more than a minute or two before you go to her, Geller says. However, if you can't respond immediately—say, you are in the shower—letting her cry until you can get to her won't do any harm. Time-tested fuss-busters include swaddling a baby tightly, gently bouncing or walking around with her snuggled in your arms or a sling, and singing or talking softly to her. Won't I spoil my new baby by holding her all the time? No. "Holding your baby helps you bond with her and reassures her that someone is there to comfort her when she needs it," Geller says. After the first month or so, though, you will want to start putting your baby down in her bassinet or crib for naps so she learns to soothe herself and fall asleep on her own, he says.

I'm confused: Are pacifiers good or bad? "Neither. I don't like to pass judgment," says Mark Swislow, M.D., a pediatrician in Skokie, Ill., and a spokesman for the American Academy of Pediatrics (AAP). Whether they're breastfed or formula fed, some babies just like to suck a lot. If you're breastfeeding and want to introduce a pacifier, wait until nursing is going smoothly, usually when the baby is around 4 to 6 weeks old. "I also advise parents to get rid of the pacifier when they're weaning the baby to a cup, at around 1 year," Swislow says. "It just gets more difficult after that."

What's normal when it comes to my baby's bowel movements? Within the first few days of birth, your baby will pass a thick, black or dark-green substance called meconium. After several days, breastfed babies usually will begin having six to eight bowel movements a day, Swislow says. These babies' stools are soft, yellow or greenish and sometimes filled with seedlike particles. The odor is faint and can smell a bit like buttermilk.

Most formula-fed babies have one or two B.M.'s a day (although they may have more), Swislow says. Their stools usually are yellow or tan, with a more pungent odor and are thicker, like toothpaste. Be aware that breast- and bottle-fed babies sometimes can go several days without having a bowel movement.

I'm breastfeeding. Is it OK to give my baby an occasional bottle of formula? "Breastfeed exclusively for the first three or four weeks," Swislow advises. That way you establish an adequate milk supply and your baby learns how to nurse. After that, you can have the baby's dad or a caregiver feed him pumped breast milk or formula if you prefer. "Don't feel guilty; doing this won't interfere with the absorption or benefits of breast milk," Swislow says. Lactation consultants caution that frequent supplementing will reduce your milk supply, so if you plan to keep breastfeeding, consider pumping.

How warmly should I dress my baby? Infants cannot regulate their body temperature until they are around 6 months old, so dressing them properly is important. "For sleep, put your baby in snug clothing that she can't become entangled in or that could cover her face and cause her to re-breathe exhaled air, since this has been linked to sudden infant death syndrome [SIDS]," Geller says. So too has overbundling; if you must cover your baby with a blanket at night, check out the safe way to do it at http://aap.org/.

Outside, in cold weather, dress her in several light layers that can be shed as needed, and make sure her hands and head are covered. Babies older than about 6 months simply need one more layer than an adult does in the same conditions, unless the weather is very cold.

What vitamins does my baby need? To ensure adequate bone-building vitamin D intake, the AAP recommends giving breastfed babies a vitamin D supplement within the first two months. "Formulas contain as much vitamin D as babies need," says Marianne Neifert, M.D., a pediatrician in Parker, Colo., and an AAP spokeswoman.

Babies also need iron. If yours is formula fed, choose an iron-fortified formula (don't worry: it won't cause constipation). Breastfed babies need a supplemental source of iron after about age 6 months. Good sources include iron-fortified infant cereal and puréed meats. If you live in an area with nonfluoridated water, you may need to give your baby a fluoride supplement starting at about 6 months.

When is it OK to let other people hold my baby and to go to crowded places? "I don't like to see babies out being exposed to germs before they are 8 weeks old," Swislow says. "An infant under this age who gets a fever often has to undergo procedures like blood tests and spinal taps," he explains. But as long as you ask adult family members and friends to wash their hands first, you can certainly let healthy people hold your newborn. Just don't allow anyone who has a cold around the baby.

Should parents lose the pets? Not necessarily, but do use common sense and err on the side of caution. "I have never heard of a cat smothering a baby, but I do recall a newborn patient whose ear had been partially chewed off by the family's pet ferret," says AAP spokeswoman Marianne Neifert, M.D. Keep pets out of your baby's room, and never leave the baby unattended in an animal's presence. And if you have a pet that has ever growled or snapped at a child (or worse), you should find the pet a new home.

When to call the doctor? If your baby strains or seems very uncomfortable when she moves her bowels, has a distended abdomen or vomits (rather than just spits up), let your pediatrician know.

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