TWO WEEK VISIT

PINELLAS PEDIATRICS    Celia DiMarco MD Kathy McNeely MD    461-3163 

Height _________% _______Weight ________ %________ Head Circ ________  %____

 WHAT TO DO WHEN A BABY CRIES

 Listen for the type of cry and watch her other behaviors.  Soon you will learn what these signals are telling you:

    • I’m hungry; I’m dirty or uncomfortable.
    • I’m bored and want to go for a walk or dance around the house.
    • I just have too much pent up energy and just need to cry it out.

Try these things:

  • Change him.
  • Try feeding her.
  • If it is soon after a nursing or bottle, try to burp him.
  • Help him find his thumb to suckle.
  • Swaddle her so her legs and arms are firmly contained.
  • Cuddle him and speak softly and comfortingly until you break through the crying.  Massage his back and limbs gently.
  • Sing to her and dance around the house (avoid shaking her).
  • Let him cry it out.

She may not need to eat but just want to suckle. Encourage him to find his thumb. Thumb suckers are better self-soothers, better sleepers.   He can always find his thumb in the night, but only you can find the pacifier.  Most kids don’t get any long term problems with thumbs or pacifiers and these can be very helpful to a baby to help him learn to soothe himself.  Don’t be afraid to try, you both may be very grateful. Babies that are held more cry less. Enjoy this time with your baby. Don’t be too rushed.  Try to make your life simpler and not do too many things. Take some time to rest and cuddle your baby.

  1. Fussy crying for no obvious reason.  It can drive you crazy and make you feel totally incompetent.  Trust me…we all have been there. Both Dr. DiMarco and Dr. McNeely had really fussy babies.  It will take a while to learn your baby’s signals and figure out what helps to soothe her and to convince yourself that it will end.  Crying is not all bad. Crying is one of the ways she communicates with you.  Crying helps a baby to tire and eventually sleep.  
  2. Keep a diary of when the crying occurs and what helps.  You will probably find that she has predictable crying periods.  You can get in the mindset that “Oh, it must be 5 o’clock and she’ll probably cry till 7 or so.”  Keep notes of what has helped in the past.  Watch what grandma or a good friend does to help soothe your baby. 
  3. Take care of yourself, too. It can be quite humbling to find how much the fussy crying can upset you.  Call a friend over to watch the baby during the fussy periods and go for a walk or watch a movieNever shake a baby. This can cause serious brain damage.
  4. Signs of serious causes of crying. If your child has been eating well, gaining weight, and is fine between crying periods, there is no cause for alarm. But if there is a sudden change in the character of the cry or progressive worsening, pay close attention. Check her over closely for localized pain, fever, decreased appetite, feeding intolerance. Call us and plan to come in to have your baby checked.
  5. Let him cry it out. You have been through your checklist and know that you’ve done everything you need to do. Check on him every 5 minutes or so. It’s ok to let him cry out all that pent up energy. He will eventually tire and be able to sleep. You may find that he sleeps really well after a period of crying. 

SIDS Prevention.  “Back to Sleep” Place your baby on his back to sleep.  Use a firm sleep surface without pillows or cushions.  Avoid a blanket.  Co-sleeping with parents has been found to be a risk for SIDS.  Other risk factors are cigarette smoke exposure and drug use.  Pacifiers at bedtime have been shown to decrease the chance of SIDS. 

Bowel Movements.Your baby’s stools will change in appearance even if you feed her the same thing each day.  Soft, yellow to brown is normal. Some babies fuss when they are about to have a bowel movement.  This is a normal response to the feeling of passing a stool. 

Diaper Rash is easier to prevent than treat.  Use a thin layer of diaper rash cream. Zinc Oxide is thick and white.  It really sticks to the skin forming a protective barrier, but it can be difficult to remove.   Some parents like Vaseline or Aquaphor.  If a rash develops…change diapers frequently, use tissues instead of wipes to wipe the bottom and wash the bottom with each diaper change.  Use a thick layer of diaper rash cream.  If the rash is not better in 2-3 days, yeast may be involved. Call during our office hours.

Sibling Rivalry is common.  Try to have your older child be Mommy’s Big Helper.  Have her bring you diapers, hold the baby’s hand and sing to the baby.  Set aside a “special time” each day for the older children while the baby is asleep.

Stimulation. Your baby knows your voice and touch.  Hold your baby and talk with her during feedings.  Do not let your baby cry hard for more that a few minutes at a time without checking for a cause.  Crying from a baby needs a response from you.  You cannot spoil a newborn infant. But if you have gone through your checklist: feeding, changing, cuddling, and your child otherwise seems fine, maybe he just needs to cry it out.  Crying will let him tire and then he will sleep well.  Check on him every 5 minutes.  Soon he should be sleeping and if not, try the checklist again.  When your baby is awake it is a good idea to have your baby in the room with the rest of the family.  Let your baby adjust to your lifestyle.  Keep the noise level normal and the temperature of the home at a point that is comfortable for the entire family. 

Signs and Symptoms of Illness. Increased fussiness, a marked increase in sleeping, or significantly decreased appetite may be a sign that your baby is getting sick. Take a rectal temperature.  Fever in newborns can be a sign of serious illness. Please call our office right away if your newborn has a rectal temperature of 100.4 or more or if you feel that your newborn is getting sick.  In the newborn period, the immune system is not mature and serious illnesses can develop quickly. 

Maternal Fatigue and Feelings of Sadness. This can be an exhausting time.  You are still recovering from childbirth and your baby requires such frequent feedings that it is hard to get enough sleep.  It is common to feel sad or overwhelmed and tearful at times. Fortunately this time will pass soon.  Try not to do too much.  Rest when your baby is resting.  Your priority is this little baby.  Accept or ask for help from others.  Encourage Dad to help and praise how he handles things, even if it is not quite the way you would have done it.

 Car Seats A rear-facing infant seat or convertible seat should be used for children up to at least 20 pounds and at least 2 years old and should be used until the seat is completely outgrown based on the car seat manufacturer recommendations for height and weight limits.