We Asked a Pediatrician About Your Most Common Questions and Concerns (cont'd)
Q: What are some other things you warn brand-new parents about?
A: Children don't grow the same every day, so I think parents need to be warned about these growth-spurt days. These are particularly trying days during the second week of breast-feeding. They lose weight after they're born, and they have to regain it after the milk comes in.
We know that babies do, in fact, grow in spurts, and the first one happens around Day 10 of life. And if you're warned about it then you know what it is, but if you're not warned about it you think your milk has dried up or that you ate something that disagrees with the baby. [During a growth spurt] all of a sudden they cluster-feed. After having established a nice pattern of feeding every two to three hours, they suddenly hit this growth spurt and grow up to a centimeter in one day, which is like you or I growing a foot. And they feed every hour for seven hours and you don't even have time to refill. Even when you know what's happening it can be overwhelming. And then, like teenagers going through a growth spurt, they sleep. So the next day you get a bit of a break. Just some basic knowledge can help parents get through and allay some of their anxieties.
Q: What do you tell new parents about babies becoming congested?
A: Babies hiccup, they sneeze, they get congested. I have parents come in who think they're allergic to the cat during the first days. Babies start to make their own mucus around a week of age and you can hear it, so parents are worried that the baby has a cold when it's really normal to be congested. We instruct them how to suction their baby's noses, but I always tell parents to ask themselves, "Does it bother you or does it bother the baby?" If they're latching on fine and sleeping fine, just leave it alone.
So many things bother the parents, but the baby isn't bothered one bit. I follow the same rule for pediatric dermatology, because skin concerns are a huge subject during well-baby visits. Usually the parents are bothered, but the baby is fine with it.
Q: Bathing a baby can be a huge concern. What advice do you give new parents?
A: There are all kinds of concerns surrounding bathing the baby — that you're going to drop the baby, and invariably you do at some point, or you bang their head walking into the kitchen or something. But fears about bathing and how to do it, and whether they're sensitive to lotions and such are common.
Lots of infants are different, and many of them don't like their baths too much. Really the only reason to bathe an infant is to get rid of the buildup of sebaceous secretions that occur in the skin folds in the neck and the arms. So really there's no absolute requirement for doing it. If parents feel the need to do it on a daily basis it's OK, but if the baby's skin is drying out, because bathing really does dry out the skin, then I usually ask them to back off. My general statement is to do it maybe once a week. It's almost as if I'm giving them permission to bathe them less often. If their child likes it and it's an enjoyable thing, great, but so often it's a struggle and I think a lot of parents would be happy to find they only had to bathe the baby once a week.
As soon as you're a parent, the marketing world descends on your fears and knows exactly what they are and capitalizes on them. Special detergents for babies are a good example. You don't need a special detergent. The Tide or Cheer you've been using are just fine. The same thing is true of soaps and lotions for babies. Johnson & Johnson Baby Magic is fine, but so is plain old Dove unscented soap. And it is unfortunate because they charge an arm and a leg for something that's "baby approved." My advice is to stay away from soaps and lotions for about the first week. Babies come out and their skin dries and they actually, for lack of a better analogy, kind of "molt" around their arms and legs. The top layer of their epidermis comes off and that can be quite concerning. Parents want to do something about it. There are lotions that you can use, but 15 minutes later the skin looks the same way. The umbilical cord can also be a source of anxiety in the first week. We actually don't do anything with it anymore. It used to be that we put alcohol on it, but it turns out that just makes the cord stay on longer. You try to keep it dry until it falls off.
