Pediatrician Offers Tips On Caring For Newborns

By Kaaren Valenta

The best advice for new mothers is also the simplest: provide lots of tender, loving care to create a lifetime bond with your new baby.

But exactly how that care should be delivered worries many new mothers.

Must babies always sleep on their backs? Should they be swaddled to prevent catching cold? Will cereal help them sleep through the night?

These questions, and many others, were addressed by Lalaine Mortera, MD, of Newtown Pediatric Services at a recent program on baby care sponsored by the St Rose Parish Nurse Ministry at the C.H. Booth Library.

“Don’t have a welcome home party for the baby,” Dr Mortera said. “People carry a lot of germs, especially toddlers who are in daycare. Make sure everyone washes their hands before touching the baby.”

What to feed a baby is the easiest question to answer, she said.

“Nurse as long as possible. Breast milk is the best for the baby’s gastrointestinal tract,” Dr Mortera said. “It’s also free, always warm, ready when needed, provides natural antibodies, and if the baby needs more milk, the breast makes more.”

Babies can nurse even if the mother has a cold, she said, and nursing will provide all the nutrition that the babies need.

“Babies don’t sleep better if given solid food at night,” she said. “This is a developmental issue. Parents should wait until 6 months to introduce solid food because otherwise allergies can develop. Except for an occasional 20-pound, 4-month-old baby, breast milk or formula are all that are needed. Even then, rice cereal only should be given.”

Babies should not be given water, because water dilutes the calories that are given and provides no nutrients, she said.

When introducing food at 6 months, parents still should avoid seven groups of food that can cause allergies and other problems: milk products, including baby yogurt; honey, because of the risk of botulism; peanuts/nuts; fish/shellfish; all citrus fruits; wheat products; and eggs. 

Babies also have very sensitive skin. Dr Mortera recommends parents use Dove soap, “a plain bar, unscented.”

“If it smells good, don’t use it, and that includes [scented] laundry detergents and fabric softeners,” she said.

The pediatrician recommended that parents talk to their doctors about supplements for their babies, especially about whether to introduce fluoride after 6 months and vitamin D, which is lacking in breast milk.

Even in winter, babies should not be overdressed, she said. “Cooler is better than warm. Babies can overheat.”

Babies always should be put down to sleep on their backs or sides on a firm, flat surface and there should be no stuffed toys, pillows, or other items in the crib. The risk of Sudden Infant Death Syndrome (SIDS) was greatly reduced when parents began to follow this advice, she said.

With insurance companies forcing parents to bring babies home within a day or two after birth, it is important that the pediatrician see the infant as soon as a day or two after discharge.

“If the baby comes home on a weekend, the visiting nurse may come to the house, but the pediatrician still wants to see the baby by Monday or Tuesday,” Dr Mortera said. “The first visit should be during the first two to four days of age.”

The pediatrician will give the parents a schedule of well-baby checkups, but parents should not wait for a checkup if the baby gets sick. “A fever of 100.4 F or higher with a rectal thermometer in an infant from birth to 3 months of age is significant. Call the doctor even if it is 2:30 am,” Dr Mortera said. “Take the temperature again, and if it is 101 or 102, go to the emergency room.”

Mothers usually have good instincts about whether a baby is sick, she said.

“If a baby is vomiting, looks sick, acts sick or lethargic, is crying for two or three hours straight, has an unusual rash, or diarrhea — especially if there is mucous, blood, or an unusually bad smell to it — call the doctor,” she said. “Set aside a small notebook to write down your concerns and the questions you might have. Take down notes.”

Spitting up is common in babies, even if they are burped, Dr Mortera said. “That’s because the muscle between the esophagus and the stomach hasn’t developed well. Colic is a behavior that often happens repeatedly between 7 and 11 in the evening. Just be sure that the baby isn’t sick and doesn’t have reflux. Sometimes a mechanical swing, the noise from a vacuum cleaner, or a ride in the car helps quiet the baby,” she said, “but often there isn’t much a parent can do besides putting the baby in a safe place and letting it cry.”

Dr Mortera said food dislikes are a behavioral issue that parents need to deal with quickly.

“If the toddler only eats fruit and macaroni and cheese, he will still be eating it at 15,” she said. “The rule should be everyone eats vegetables, three spoonfuls. If the child doesn’t eat it, there is nothing to eat until the next meal — tough love.

“Wait until breakfast for the next meal. Don’t stick in a bottle at 3 am or you are defeating the purpose. Everyone in the family must cooperate and this method will work in three to five days. It is conditioning while you still have control.

“You will be glad later. It is nice to have children who eat everything.”

Dr Mortera’s presentation is available on videotape at the C.H. Booth Library, as are all of the Parish Nurse Ministry-sponsored programs.

Dr Mortera is a graduate of the University of Philippines College of Medicine and completed a pediatric internship at Bridge Hospital/Yale University School of Medicine, and pediatric residencies at Northshore Cornell University Hospitals/Cornell University Medical College and Westchester County Medical Center/New York Medical College. She also completed fellowship training in clinical genetics and dysmorphology at Montefiore Medical Center/Albert Einstein College of Medicine.

A fellow of the American Academy of Pediatrics, Dr Mortera joined the Danbury Hospital Department of Pediatrics in 1997. She resides in Newtown with her husband, Herbert, and their two children, Brittany and Christian.

 For more information about Dr Mortera and the Danbury Office of Physician Services, PC., view www.DOPS-MD.com