New babies bring lots of joy—and bundles of questions

When it comes to the care of your child, there’s no such thing as a dumb question. This is particularly true for new parents. We caught up with Stanford’s Dr. Hart-Cooper who practices at Peninsula Pediatric Medical Group in Menlo Park to provide advice on some of the most common questions asked by new parents.

Q: How can I get my baby to sleep on a schedule?

Dr. Hart-Cooper: Babies younger than two months are transitioning their sleep—and won’t be setting up any permanent sleep habits. When babies are developing in the womb, they spend about nine months in near darkness sleeping whenever they like. After they are born, it takes time for their developing brains to get used a day-night cycle. On top of that, their stomachs are small so they get hungry every few hours. For the first two weeks, babies will feed pretty frequently (about every 2-3 hours) as they try to regain their birthweight and will sleep in between. From two weeks to two months, these feedings become more efficient (aka shorter and less frequent) and will gradually space out, letting your baby sleep for longer stretches of time.

Between two and four months, you can start to build healthy sleep routines. Start to teach your baby the difference between day and night by keeping the night boring (avoiding play time and keeping lights dim – even during feeds), and the day more exciting (play time, bright lights). It’s also important that babies learn to fall asleep on their own. Place them in their safe sleeping space when drowsy but not asleep. Babies like to fall asleep and wake up in the same place – it can be startling if they fall asleep in your arms and wake up in their bed. Imagine if you fell asleep on your couch then woke up in your bed!

At six months, most babies will sleep through the night. If your baby is still a night owl, see if you can make his/her nighttime meals more boring—and speak with your pediatrician for more tips.

Q: Should I be worried about a fever?

Dr. Hart-Cooper: In general, we are more concerned with fever in younger babies and unvaccinated babies. A fever is defined as a rectal temperature of 38°C (100.4°F). In newborns younger three months, every fever needs to be evaluated so call your pediatrician as soon as possible. We don’t recommend fever reducers in babies younger than three months because they can mask a fever. In children who are older than three months and are vaccinated, it’s best to discuss with your pediatrician as practices vary. In general, a fever should be evaluated if it’s over 102, lasts 48-72 hours, doesn’t have a clear source (such as a runny nose or cough), your child has a rash, or if your child isn’t acting like his/her normal self after taking a fever reducer such as acetaminophen.

For children who are unvaccinated or incompletely vaccinated, it’s best to discuss with your doctor. Incompletely vaccinated children are at risk for more serious infections and often require more evaluation.

Q: When is it OK to let my baby sleep on her/his stomach?

Dr. Hart-Cooper: We always recommend that your baby sleep on his/her back—for naps as well as bed time. Naturally, when babies start to roll, they turn into acrobats and can end up in all sorts of positions,

and you aren’t expected to keep repositioning them throughout the night. But putting down babies to sleep on their backs is the safest position.

Also be sure that your safe sleeping space has three things: 1) your adorable swaddled baby; 2) a firm mattress; and 3) firm protective walls (such as a bassinet) to keep your baby from rolling out. Extra items such as hats, bumpers, pillows, blankets, stuffed animals aren’t necessary (and aren’t safe).

Q: My baby’s poop looks weird. What is normal for a newborn?

Dr. Hart-Cooper: Newborns have a really wide range of poops—you’ll be surprised! Poop starts out as black (meconium) and transitions to yellow (if breastfed) or green/brown (if formula fed) in the first week of life. After poop transitions, any color except pale, black or red (blood) can be normal if your baby otherwise looks happy and healthy. Frequency can also vary substantially child to child. Some breastfed babies can go up to a week (or more) between poops! As long as the poop is soft when it comes out, this is very normal. Once you introduce solids to your baby (at around four to six months), some babies can get mildly constipated and have hard stools. If that happens, it’s easy to fix – just give your pediatrician a call to go over ways to help make your baby’s poop more comfortable.

Q: How can I make vaccinations easier for my baby?

Dr. Hart-Cooper: The calmer and more comfortable the parents are, the easier vaccinations are for children. Be sure to discuss any questions you have beforehand (ideally during the prior visit). We know that vaccines are safe and protect kids from unnecessary illnesses, missed school days, and missed parent work days. In terms of timing, it’s best to stick to the CDC-approved, standard vaccination schedule. It means fewer visits to the doctor’s office and the earliest protection possible. Spacing out vaccines can be harder for kids because it means more visits to the doctor’s office and more vaccination days.

After a vaccine, your child may have no reaction, or you may see your child’s body start building immunity through a low-grade fever or mild redness to the vaccination site. These can be managed supportively – making your child comfortable with a little TLC and allowing it to pass. If you are concerned about a potential reaction, it’s best to speak with your pediatrician.

Q: How can I help my older child handle the addition of a new baby sibling?

Dr. Hart-Cooper: Involving your other child in your new baby’s care is a great way to help the big brother/sister feel responsible and proud to be a big sibling. Predictable, simple tasks are great—throwing dirty diapers away (or getting new diapers), washing the clothes together, or holding the bottle while your hands are full. Thank and praise your child afterwards.

Plan a predictable time with just you (and/or your partner) and the big brother/sister each day. It doesn’t have to be long, but do your best to make it consistent.