Being a new mom is an exciting and amazing experience. And when it comes to your baby’s health, you want the proper tools and knowledge to prepare you for when your little one leaves the hospital/birth center. If it’s your firstborn, you’re often clueless when it comes to raising a baby which is totally understandable. When you visit your pediatric appointments at the Southwest Care Center, or whatever center you have chosen, you can ask as many questions you like but what happens when you go home and have a question? Who will be able to answer it?
Here, I interviewed Dr. Binny Chokshi, to get her expert opinion and answers to important questions moms have for pediatricians when bringing their newborn home. And it was so helpful for me too, since I interviewed her during my pregnancy. When I came home with little Laila, I truly felt prepared!
Binny Chokshi M.D. is a graduate of Brown University and Albert Einstein College of Medicine. She is currently completing her specialty training in pediatrics in Washington, D.C.
Chai Mommas: How do you know if your baby is gaining enough weight in the first few months?
Dr. Chokshi: That’s a great question. So in the first few well visits, you and your pediatrician, (and dad), will engage in a lot of discussion on this topic. Your pediatrician will have what’s called a growth chart and something you will take a lot of pride into looking at each visit. The amount of appropriate weight gain is determined on how baby is growing overall on the curve of the chart. Basically, each baby grows in their own certain way so there isn’t a definite weight a baby should or shouldn’t be. But there are some “rules” we can follow from birth to the 2 week visit, such that baby may have lost weight right after birth but then should gain it back by 2 weeks, (be at birth weight). From then to 6 months, baby may gain an ounce a day and by 6 months would be double his/her birth weight. After that, it slows down to about ½ an ounce a day so his/her weight should triple by 1 year of age. But again, it is all really according the the curve of growth chart, and the first plot is when baby is born.
Chai Mommas: Speaking of well visits, what are the minimum check up times once your baby is born and what do these visits entail?
Dr. Chokshi: Check up times vary since each pediatrician has their own preference. Most will see baby within 3-5 days from discharge if not sooner. The focus of these visits are on how baby is feeding and growing and on the routine you are developing with baby. A large part of it will also be how you, as a new mom and new dad, are adjusting to the bundle of joy in your home. Babies require a lot of love and care, but a good pediatrician will also focus on how the two of you are taking care of yourselves, as well. After the initial appointment. you will most likely have a 1 month, 2 month, 4 month, 6 month, 9 month and 12 month visit, assuming your baby is doing well and doesn’t need to be seen between these visits. Vaccines usually start at the 2 month visit after any that were administered in the hospital at birth and may continue to the 4 month, 6 month and 12 month visits, but that is flexible and your pediatrician will review that at your first visit with him/her.
Chai Mommas: So in regards to vaccines, in your opinion, what vaccinations are mandatory? Are there any that are more important or not necessary?
Dr. Chokshi: As a pediatrician, I would recommend all of the vaccines. There is a lot of effort and evidence that has gone into research that the CDC has conducted in regards to the vaccines schedules and which are good and which aren’t. Common questions parents have are what are the side effects and if there is a link to autism. In regards to autism, the data is not there to create the link and in regards to the side effects, the most common one is usually pain or irritation at site of vaccine. So that is pretty pale in comparison to the diseases in which they prevent and effects of not being vaccinated for them. But this is something that you can discuss with your pediatrician and decide on what works for you and your family.
Chai Mommas: Thanks, I know, it’s definitely a controversial topic. For my family, we decided to vaccinate on what viruses or diseases the vaccines protected against that were fatal to our baby after discussing how we felt with our pediatrician like you said is best to do.
Chai Mommas: Our next question has to do with something all moms see a lot of- stool and spit up! So we want to know, what is “normal” to see vs. what is something to be worried about in regards to your baby’s spit up and stool?
Dr. Chokshi: It can be completely normal for babies to spit up after feedings, but its good to look at how the baby looks overall. Is the baby just spitting up but happy and smiling, and comfortable? And on a macro level, is your baby gaining weight appropriately? If yes, then we aren’t too worried about small spit ups post feed. Something that can happen in the very beginning though is overfeeding the baby. When you come home from the hospital sometimes in the first few days of your baby’s life, a common desire is make sure you are feeding every time baby cries, but something I always remember learning is that the size of the baby’s stomach is the size of a marble when she or he is born, so feed often, every 2 hours or so, but in the first few days they can only hold about an ounce. If you notice there is blood in the spit up, (also in the first day or two you may see some, since they swallow moms blood from placenta), just call your pediatrician. And also, if it is green in color then definitely call your pediatrician.
Chai Mommas: What about poop?
Dr. Chokshi: You will start thinking about poop more than you ever have when your baby is born, (haha). In the first couple days of life, there may not be any regularity to how your baby passes stool and that is okay. In those first few days, actually, you may see what’s called meconium, which is a combination of all the things that your baby swallowed while in your belly, like amniotic fluid and mucous, and the stools will be pasty and extremely hard to clean, plus blackish-greenish in color, but after it passes through, if you are breastfeeding, they will become earth tone color stools that might be grainy or curdled. They may also pass stool after every feed or once a day. It may take time if they develop a pattern, if they even do. Formula fed babies stool less frequently, but it’s still hard to say how much they are going to stool. Times to be concerned are if you see very pale stools, which are a sign of jaundice, or if you see blood in the stools then call your pediatrician.
Chai Mommas: Lastly, we never want to think of emergencies, but we know fever can indicate an emergency in a baby. What is considered a fever and what do you do if your baby has a fever?
Dr. Chokshi: That’s also a great question. Anything greater or equal to 100.4 degrees F is considered a fever. And what is important about checking the temperature, is to do so rectally, and that is because it’s the best way to get core body temperature. Moms worry about hurting the baby or ask why they can’t just do it orally, but the rectal temperature is the most accurate. Under the armpit is alright, but rectally is the best. You can get some vaseline and apply it to the tip of the thermometer to help in obtaining it. Please don’t also fall trap to the thermometers out there that say you can just wave them over the forehead, since those are not accurate. And it is important to get the exact reading, because if your baby does have a fever and even if the baby looks well, when you call your pediatrician and go to the hospital, they will likely perform an infectious work up.
Thank you Dr. Chokshi for chatting with us and for these thorough and informative answers! Mommas, if you have any similar questions and answers we all can learn from, let us know below!