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Becoming a new mom raises a lot of burning questions, especially during a pandemic. To help new parents, Atrium Health hosted a live panel with 3 pediatric experts to offer tips and advice to help first-time parents navigate newborn care.
New parenthood introduces moms and dads to unprecedented joys and challenges. To help answer some of your burning questions about entering this new chapter of life amid a global pandemic, two pediatricians - Rhonda Patt, MD, a pediatrician at Atrium Health Levine Children’s Charlotte Pediatric Clinic – SouthPark, and Chpryelle Carr, MD, a pediatrician at Atrium Health Levine Children’s Waxhaw Pediatrics and lactation consultant Jan Ellen Brown shared their knowledge on a Facebook Live panel.
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These helpful tips provide advice, educate, and encourage new parents of newborns to make informed decisions and to be well prepared for the journey ahead.
Question: What advice do you have for parents navigating the unique season of COVID-19 with a newborn?
According to Dr. Patt, everyone worries about COVID-19 – even if you’re not a new parent – but it’s particularly stressful when a parent is ready to have a baby. The fall and winter is flu and RSV season, so we actually would give the same advice now compared to any other year. If you have a newborn and someone has cold symptoms, that person should not be in your home. Something that causes just a cold for an adult can be severe for a baby.
Everyone wants to meet a new baby, and it's possible to do these things safely, but you have to be deliberate about your plan and approach. Limit your guests to people who are important and close like grandparents, while taking precautions like wearing masks and washing their hands. Visitors from outside the household who are toddler age pose an additional risk as toddlers carry a lot of dangerous viruses to newborns.
Dr. Carr added that we should be extra cautious, practice more hand washing, and wear masks to keep newborns safe. Though we are in a pandemic, the plan is still the same to reduce the risk of virus transmission to newborns.
Q: Could you walk moms through the first few months, vaccines, and maintaining a vaccine schedule?
Dr. Carr responded that new parents should be prepared to see their child’s pediatrician a lot. This is to make sure that the baby is developing appropriately. Your child will have a checkup just a few days after being discharged from the hospital, then have frequent visits to get accurate measurements, vaccinations, and more.
You’ll most likely see your pediatrician 3 to 4 times in the first month. This is to keep up with the vaccine schedule that starts in the nursery with the hepatitis B vaccine. Your baby should follow a vaccine schedule, with significant immunizations occurring at 2, 4, 6, 12 months and beyond. This schedule is based on the science that validates giving children immunity to potentially dangerous diseases early.
Q: In your expert opinion, what are the benefits of breastfeeding for both the baby and the mom? And for those who may not be able to breastfeed or choose not to, what are the alternatives?
Human milk for human babies offers many benefits, reports Brown. Firstly, the act of breastfeeding and pumping helps give mom the “love hormone” oxytocin to help her feel relaxed and bond with her baby. It also shrinks the uterus and provides antibodies for colds, flu, and even COVID-19.
Atrium Health is a Baby-Friendly designated hospital so it takes extra measures to support and initiate breastfeeding. If things are not optimal, we can provide care in the hospital and outside too. If there are difficulties in breastfeeding, we can help at the hospital and at outpatient facilities too. Alternatives to direct breastfeeding include pumping and formula supplementation.
Q: To leave the hospital, parents must have chosen their pediatrician and scheduled their first appointment. What are some helpful tips to share with new parents as they identify a pediatrician for their child?
Dr. Carr advised that parents should consider factors like the location, hours and days open, and the size of the practice. Parents have many options to suit their preferences. Being affiliated with a world-renowned hospital like Atrium Health Levine Children’s, which is nationally ranked in 8 specialties by U.S. News & World Report, is also a positive aspect. If your child has an emergency, he or she can get the best care possible- as pediatricians can communicate with specialists through e-consults to determine the best care plan for your child’s specific needs.
Be sure that the practice style fits you like a great black dress. Don’t be afraid to try different pediatricians until you find a good fit. You need great communication and a good relationship with your pediatrician. Overall, your care provider should help you meet your goals and keep in mind your medical family history, allergies, or other health needs. Click here to learn about Atrium Health Levine Children’s pediatric primary care and finding a pediatrician.
Q: What are the top 3 questions new moms ask and what are your answers?
Dr. Patt shares the top questions she gets from her patients:
- #1: Is my baby getting enough food/breastmilk? This is a big concern for moms after going home because they can’t see or measure it for nursing. They should watch for wet diapers, bowel movements, and come for checkups to make sure the baby is developing well.
- #2: Can we use a pacifier? In newborn nurseries, pacifiers are discouraged because they can make it hard for the baby to nurse. However, it’s fine to use it once breastfeeding has been established to soothe the baby after they have eaten. It should not be used in place of a feeding, but as a soothing tool after the baby is fed and cared for.
- #3: When is the baby going to sleep at night? Every baby sleeps through the night at their own time. Though your pediatrician can’t give you an exact timeline, he or she can give you tips to develop good sleeping habits. However, it’s important not to rush this because the sleep center of the baby's brain develops at its own time.
Q: What are your top breastfeeding tips and do you have any advice or resources for moms struggling with breastfeeding?
As a lactation consultant, Brown wants parents to know that help is available after the delivery so they can resolve any issues early and effectively. Breastfeeding is something “natural that doesn’t come naturally”, so there are a lot of resources to help. Seek out help if there is pain during feeds or not enough wet/soiled diapers.
Get the milk supply established by frequent feedings — don’t expect a schedule or routine in the first week. Try to sleep when the baby sleeps and take care of yourself when you have a break. Feed early and often, look for cues for when the baby is awake so they don’t fall asleep at the breast.
Make a log of feeding times and urine/stool output. These facts can be hard to remember when you’re sleep-deprived, but it helps you and your support person to be on the same page. Overall, try to get a good start, don’t give up, and don’t quit on a bad day!
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Q: My daughter is 9 months old and has not been inside a store or public place. Am I being too cautious because of COVID-19? I want to make sure I introduce her to germs and build her immune system but I’m struggling because of the pandemic.
Dr. Patt assured parents that being cautious right now isn’t a bad thing. Since a baby is too young to wear a mask safely or effectively, they are going into public places unprotected. Overall, it is safer for a baby to be at home at this time. Not only is COVID-19 surging, but it is also RSV and flu season. Avoiding public places for a couple more months is a sound strategy to minimize risks.
Also, babies don’t need to socialize until they are closer to 3, so parents should not feel guilty about pulling kids out of daycare. When it comes to the immune system, it is okay for it to happen later in the kid’s life. There are also passive germs a toddler will get from the parents going to work and grocery stores, so the baby is going to be exposed to things to build immunity.
Q: A big adjustment for many parents is sleep. Do you have any tips about adjusting to the new sleep routine of having a newborn? Is there anything parents should be looking out for, such as sleep regressions?
Dr. Carr emphasizes that sleeping is different for each little one. Newborns don’t typically sleep through the night, but instead, need to eat every 2 to 3 hours. To make the first months go easier, mimic being in the womb. Use white noise, vibrating bassinets, swaddle, and walk around with the baby gently instead of being still. However, every child is different, so call your pediatrician for advice that is best for your child.
Newborns are usually sleepy and doze off anywhere, but after a couple of months, they do commonly experience sleep regressions. Continue to establish safe sleeping habits like putting them on their back to sleep and swaddle. Also, don’t compare your baby’s sleep with what you see on social media. Every baby sleeps through the night at their own time and in their own way.
Q: Should you wake a sleeping baby?
Dr. Carr and Dr. Patt agree that it depends on the age. If a newborn hasn't gotten back to her birth weight, you should wake the baby to feed every 2 to 3 hours. At that time, mother’s milk is just coming in, and it’s a matter of supply and demand. The more you stimulate the breast, the better nursing will be.
After the baby passes its birth weight and continues to gain weight well, don’t wake the baby. Also, you should make sure that the baby doesn’t keep days and nights confused. If your older baby tries to nap for 5-hour stretches during the day, wake your baby so that they can sleep more at night.
Q: What is the average time it takes for milk to come in after delivery and is it okay to supplement until then?
Brown states that within 48 to 72 hours you can see a milk surge — and at the first 4 to 5 days at the very latest. If the mother doesn't feel like her breasts are changing or if the baby isn't feeding with several soiled/wet diapers, call your pediatrician.
If the baby needs extra milk, the mother can pump or offer formula. Early intervention and milk removal from the breast is the key to establish a good milk supply.
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Q: What baby medicines and first aid items are good to have at home for a newborn?
Dr. Patt and Dr. Carr advised parents to keep a bulb suction and nasal saline drops. Newborns can’t have any cold medicine, so these two items are effective at soothing colds and congestion. Tylenol can be administered after 2 months, and other types of medication are safe after 6+ months. Diaper cream and skin lubricants like Vaseline and Aquaphor are also key staples. Unscented baby lotion and a cool-mist humidifier are also good things to have in the winter to combat dry air.
Q: How do you know if the baby’s bowel movements are regular and are there any red flags to look out for?
Newborns have what is called meconium the first few days after the hospital, and it's essentially a black stool. Then, it will turn green or yellow depending on whether you breastfeed or formula feed.
Dr. Carr advised that if you notice any red, black, and white colors or if the baby’s stool has mucus-like consistencies, call your pediatrician. Questions can come up at any time of the day, so new parents should sign up for a MyAtriumHealth account where they can ask questions and send any images to their pediatricians.
Q: What other things can surprise first-time parents about having a newborn?
Dr. Patt observed that many new parents are surprised that they are no longer in control. This can be particularly difficult now with social media when you can compare factors like breast milk supply and types of births. There are going to be bumps in the road all the way along and that’s okay. Take things day by day. Every week it changes, and don't worry about the future.
Q: Any advice for partners supporting new moms in the breastfeeding process and beyond?
Brown says that partners can do a lot to support a new mom, even if they can’t nurse. They can help her with food, drinks, burp the baby, and do skin-to-skin. Partners can also run all the other logistics of the household like take out the dog and entertain older children. These tasks will take much of the burden off the mother and give her time to establish a good nursing routine.
Having questions about newborn care is completely normal, and the pediatric experts at Levine Children’s are here to help you throughout your parenting journey.
This article originally ran in Atrium Health's Daily Dose.
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