Creating a Family: Talk about Adoption & Foster Care

Basic Baby Care

August 02, 2023 Creating a Family Season 17 Episode 31
Creating a Family: Talk about Adoption & Foster Care
Basic Baby Care
Show Notes Transcript

Are you expecting the placement of a newborn? Don't miss our conversation about the latest information on baby care with Kristen O’Dell, a board-certified Family Nurse Practitioner with almost two decades of working with over 10,000 newborns and their families in her hospital practice of Neonatology and Newborn Medicine.

In this episode, we cover:

  • Feeding
    • The vast majority of adoptive parents will bottle-feed their baby. How to choose a formula.
    • Is liquid or dry formula better for the baby?
    • How to sterilize the dry formula?
    • Do you need to sterilize bottles?
    • What type of bottle is best?
    • Does the bottle type differ if the baby is born premature or has Neonatal Abstinence Syndrome?
    • Does the temperature of the formula matter?
    • Can you make the bottles up once a day, or do you have to make it fresh for each feeding?
    • When should you consider a specialized formula, and what options do you have?
    • How often should a baby eat?
    • Other feeding options: adoptive mother induce lactation to breastfeed; donated breast milk.
    • How do you know if your baby is getting enough food?
    • If your baby spits up a lot, when should you worry that they aren’t getting enough food?
    • When to introduce solid food? 
  • Sleep
    • What is a typical wake/sleep pattern for a newborn?
    • When should you expect your baby to sleep for 5-6 hours?
    • Is the wake/sleep cycle affected by prematurity or Neonatal Abstinence Syndrome (NAS)?
    • At what point can you start trying to get your baby to not wake up many times for a feeding at night?
    • Will introducing solid food, even if watered down, help your baby sleep through the night?
    • How can you establish healthy sleeping habits for your baby?
    • When do most babies start sleeping through the night and what is “sleeping through the night”—how much sleep?
    • Safe sleep practices: sleeping on the back, no pillows, blankets, bumpers, stuffed animals
    • Sleep training 
  • Poop
    • How often should babies poop? What is normal?
    • What does the typical healthy newborn baby poop look like?
    • How do you know if there is a problem?
    • How can you tell if your baby is constipated? And what should you do?
    • What type of diaper is best?
    • What type of baby wipes are best?
    • How to treat diaper rash?
    • How can you tell if your baby has a yeast diaper rash?
  • What is colic?
  • How do you treat colic?
  • What is the current thinking on circumcision?
  • Tips for new parents.

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Dawn Davenport  0:00  
Welcome everyone to creating a family talk about foster adoptive and kinship care. I'm Dawn Davenport. I am the host of this show, as well as the director of the nonprofit creating a Today we're going to be talking about basic baby care. We will be talking with Kristin O'Dell. She is a board certified family nurse practitioner with almost two decades of working with over 10,000 newborns and their families in her hospital practice of neonatology and newborn medicine. Welcome, Kristen, to creating a family.

Unknown Speaker  0:34  
Thank you, Dawn, thank you so much for having me. I'm so excited to be on your show. Today,

Dawn Davenport  0:40  
we're going to hit all the high points here, feeding, sleeping and pooping. And then make sure you hang around to the end because we will have tips for new parents, New Parents of newborns. So this should be fun. All right, let's begin with feeding. Now, the vast majority of adoptive parents will be bottle feeding their baby. So how do you choose a formula?

Speaker 2  1:07  
That's a great question. So typically, the discharging hospital will let you know what the baby has been feeding in the hospital, it's a good rule of thumb to try to keep the baby on that formula and not switch right after going home. There's a lot of transitional things going on. And we don't want to implement any gut issues. So if we don't have to, I would try to keep the baby on what the baby is tolerating in the hospital. Now that could differ depending on if the baby's preterm has any already digestive issues or full term. But on the whole full term, healthy baby would usually be feeding Similac or Enfamil, without any extra calories or additives to it. And typically, in today's world, those two are getting easier to find. And it's not as stressful as it once was a little while back. So mostly Similac or Enfamil.

Dawn Davenport  1:56  
All right, not all by any means. But some of the babies that our families will be working with will have been exposed prenatally, they may be born premature, or they may have neonatal abstinence syndrome, this formula differ at all for those babies,

Speaker 2  2:12  
in some cases, so some premature babies, depending on how premature they are, may be sent home a higher caloric formula, like AdvoCare, which has 22 calories per ounce instead of the regular 20 calories per ounce. So that way, when the baby's taking the certain volume that they're taking, they're getting extra calories packed in there to hopefully help them with weight gain and catch up if they're premature. And in the same case, sometimes babies do go home with neonatal abstinence syndrome, because of the nature of that disorder, they can have access moving around, and may burn through more calories, which also may potentiate, their risk for losing more weight because of their excess metabolism. And you know, sometimes crying and moving and just everything that they go through. And so sometimes they also are sent home with extra calories as well. But if they are showing consistent weight gain in the hospital prior to delivery on a regular formula, and that's what they'll be sent home on. But if they had a weight loss issue while in the hospital, we will typically increase their calories in the hospital, make sure they tolerate that make sure they're gaining weight on that and then send them home on that. So before you buy any formula, you would probably wait almost close until discharge time because sometimes formulas can be changed up to very close to discharge time. So you don't want to go and buy a whole bunch of formula and then have the baby come home with something different just days before they come home. So I would say you know it's a good idea if you know what the baby's taking sometimes our neonatal absence babies are in the hospital for a month, you may have an idea they're coming home on this formula, maybe get one of it just to have and then if you're interested more in buying the bulk or you have the opportunity to buy both wait until you get closer to going home and you know what the baby's definitely going home on.

Dawn Davenport  3:56  
That is very good and practical advice. Especially because oftentimes, we're also anxious that we want to get everything done we've been waiting for this baby for a while we really want to get everything laid out so there's a chance to kind of go overboard so is liquid or dry formula better for a baby and by dry I mean powdered formula that that you then mix with water

Speaker 2  4:19  
now again this will come in finances come into play with answering this question liquid formula is more expensive than powdered formula if you can afford it or it's within the budget or within some people have certain insurances that will pay I think it's great to start with a ready made formula for a couple of reasons. So that would be a liquid formula. One is there a sterile when they come so you don't need to sterilize them powder formulas need to be sterilized and I can go into that further and probably wonder the who the next other questions but for a newborn baby or premature baby for sure. But any newborn baby less than two or even three months. If you can afford it, I would use ready made formula it's easier for you It's quicker to prepare, you can travel with it a little bit easier typically. And the risk of contamination or requiring sterilization is really none. So as far as ease goes and ease of mind, I would always use ready made, I've done so for my own children in the first couple of months of life. And the reason for that is once they get to be two, three months and beyond, they have more of an immune system. And so the risk to them, if they did get some type of contaminated formula lowers their have a more of an ability to fight off an infection at that older age, some parents still choose to use a sterile liquid formula even beyond that, but they're taking so much formula by that age, it usually becomes cost prohibitive. But when there's so little, and they're taking such small amounts every three hours, you're usually able to afford a liquid formula for at least the first month. So I would suggest using that as a goal for yourself when taking home a baby just for ease of mind, time saving, and just easier for you and for the baby.

Dawn Davenport  6:02  
I'm glad you raised the issue of sterilization. So I have two questions on that one, you mentioned that you had to sterilize with dry formula. So that's one question. And the second one is, is it still necessary to sterilize bottles, if you are washing them in a dishwasher? So first answer the dry formula, and then tell us about what we need to do about bottles.

Speaker 2  6:26  
Okay, so this is a common question that I get, and one that's often answered incorrectly. current guidelines, especially from the CDC, and this is easily searchable on the CDC website, I'm happy to provide a link, I also have some references that I use for my clients. Basically, when the powdered comes, a lot of people will boil the water thinking they need to boil the water and then they'll cool the water and mix the formula in with the cold water. But you really want to boil the formula because the powdered formula itself can be contaminated with cronobacter. And this happens sometimes in packaging or that facility. So it doesn't come sterile, there is a segment of risks that there can be a contamination in that powder. So you want to boil your water, let it cool for a couple of minutes. So it's not actively boiling, then you mix your powder in with it. And then you're going to cool that formula enough for the baby to eat it, you would want to check it on your wrist before you feed. If it's really still hot and the babies screaming right now for it, you can use some ice water like swirl it around and like the little ice water baths that you can give that bottle to the baby right away. Now it's such a pain in the tush to have to constitute formula and boil it like that, I'm usually suggest that my clients make what they need for the entire day once in the morning, it really isn't time effective to have to boil eight times a day while you're trying to feed the babies. So you would calculate what you would need for a 24 hour period, you would boil that amount of water mix that amount of powder and keep it in a larger, clean sterile some type of clean container in your refrigerator. You would pour from that into your bottle each time you needed a bottle and warm that bottle up in a bottle warmer. And that's how you would give formula throughout the day.

Dawn Davenport  8:03  
So do we need to sterilize bottles regardless of whether we're using liquid or powdered? And assuming that we're running them through a dishwasher?

Speaker 2  8:11  
I would say no running it through a dishwasher is sterilization enough. If you don't have a dishwasher, you can get away with washing bottles through hot soapy water for your reason your bottle often, then you can use hot soapy water in between. But then once at the end of the day, if you don't have a dishwasher, I will put it in a bottle sterilizer.

Dawn Davenport  8:29  
All right, and what type of bottle is best? What are the most current styles of bottles that are being used? And is there a preference either through ease or through for the baby or whatever depending on the type we use.

Speaker 2  8:42  
So typically with the babies, you're mentioning that you maybe take you home neonatal abstinence syndrome, babies premature babies, really a bottle is going to differ from baby to baby. So I will say that you will have some babies that do better on some bottles and some babies prefer another bottle. It's the feel of the silicone, it's the shape of the nipple. Also think about the shape of their mouth. So some things just fit in differently like a puzzle and each baby is different. But you really want to try to prevent air intake when you're bottle feeding a baby eight to 12 times a day. And so we usually suggested Dr. Brown's battle for neonatal abstinence syndrome baby that's one great one to start with. Also, I like the Playtex vent air bottles very much for those babies as well. My biggest advice to bottles is don't buy 10 of the same by three to five different brands of bottle one each. So you have maybe a man bottle maybe a Playtex vendere, Dr. Brown's and maybe two other ones that you see in there. I'm blanking on two other names but there's lots of different brands but the mams are popular. Dr. Browns, and the Playtex vendere. I would get at least one each of those and when you get the baby home with you, you're going to try each one. Don't try each one once. You may have to try each one a few times until you find what when the baby feeds better with doesn't have milk spilling out of the mouth so there's not a lot clicking sounds or milk loss, you're looking for those with fit as far as the nipple goes. And then you're also assessing how much gas the baby has afterwards, if the baby seems uncomfortable, how fast the baby can feed through that battle, now you want them taking the feed and about anywhere between 15 to 20 minutes, if they're taking a really long time for the Wii, that may not be a good fit for some reason, or you may have to have an evaluation done. If they're sucking it down in five to 10 minutes, that might be too fast, they may get a lot of air and they may then throw up afterwards. So you want a nice, even flow with that nipple. And so you're kind of looking for these things and testing those bottles. Once you find one out of those that you really like and your being jives with, then you're going to go and get eight to 10 of them. So you have them and you can watch them and don't have to watch them after every single feed

Dawn Davenport  10:47  
does the temperature of the formula matter. So you do

Speaker 2  10:50  
not have to warm your baby formula that is usually parent or baby preference. But most babies do like their formula warm, or even room temperature feeding a baby cold formula might be shocking for them. If you kind of think how it feels like to swallow ice cream, it may be a little shocking at first, so they may not be ready for that. If you're doing that because of necessity for some reason, they can get used to that there's nothing wrong, you won't hurt a baby by fitting the formula from the fridge if they're screaming and they want something. But typically babies do prefer their formula is warmed up a little bit and then you just check it on your wrist to make sure it's not too hot. And I would suggest doing so for a baby for at least the first few months of life. After they're a couple of months old. They're sitting up more than me start eating some foods, you could probably start feeding them room temp or even chilled drinks.

Dawn Davenport  11:38  
All right, we certainly know that some babies eventually get put on a specialized formula. What are the symptoms? What would you as a parent look for to determine whether or not you should be talking with your pediatrician or nurse practitioner about changing to a different formula or moving to other specialized formulas?

Speaker 2  11:57  
Yes, this is definitely a conversation you want to have with your pediatric provider, I would not be changing baby's formulas on your own or based on what a friend said or what you do with your other child, it's definitely a conversation you want to have with your provider first. And also to make sure you're doing so safely for the baby. Switching like from one bottle to the next with different hormones can cause an issue with our gut because of the difference in the osmolarity of different formulas. Some babies tolerate a switch fine, and some babies need a more gradual switch. But things that you would look for in order to start that conversation with your providers would be blood in the stool that can indicate possibly a milk allergy and might require you to change the formula to something that's lactose free. If you're noticing spitting up after every single feed, there might be reflux going on and you can talk to them, they might decide to do some type of medication for that, or even some type of a formula that's designed for reflux, those formulas can have additives to them to try to weigh them down and keep them down in the belly so they don't come up so easy. So there are different treatments that you can do for some of these GI issues. Sometimes it's a switch in Formula, and sometimes it's not, but basically blood in the stool spitting off after every single bottle, a baby who's really colicky, which I can describe and get into that later on. But if you think your baby is colicky, it's another conversation to have. Sometimes there are more gentle formulas, we're not sure exactly what causes Kali, but it could be GI upset. And so you may want to play around with different formulas for that. And another big thing that you may want to talk to your pediatrician about switching parameters would be poor waking or failure to thrive. So a baby who's going home premature or with neonatal abstinence syndrome, may go home and not really be gaining weight or going along the road curve like the pediatrician would like. And so in that case, they may want to also change the formula at that time to add more calories, protein, vitamins, minerals, and things like that to support their growth and development.

Dawn Davenport  13:52  
So how often should a baby? Of course, that question depends on how old the baby is. So let's say a baby within the first month of life, and then all the way up to like six months? How often should they be taking a bottle?

Speaker 2  14:05  
Well, you took the words right out of my mouth, I was gonna say that answer will differ vary greatly, depending on the age of the baby. You know, many parents will ask that question to a pediatrician who may answer it and then they think that answer stands for a really long time. But really, that answer changes as time goes on. So basically, the baby should if you're taking home a newborn baby, they're going to eat on demand, which means pretty much when they wake and cry, they're probably hungry. And it's going to be an average of about every two to three hours. So that's going to go on and a formula feeding baby will usually be on somewhat of a schedule. It's different for a breastfeeding baby because they haven't quite gotten established with breastfeeding. But for a formula fed baby, they're going to eat about every two to three hours. Now when they get to be about anywhere between two months old, they might start sleeping more through the night you're talking like you may get a break of five to six hours so they may skip a feed in the middle of the night and give you a little more time sleeping, you wouldn't want to wake them, there's no need to wake a sleeping baby to eat unless you're having an issue like failure to five poor waking, and your pediatrician advises you to feed on schedule every two to three hours. And those cases, you might need to wake the baby to make sure they're taking in the caloric intake that they need. But other than that, you basically when they're zero to two months, you're feeding them on demand. Usually, when they wake up, it's an average of every two to three hours. Beyond that, they will probably feed about every three hours during the day. And then at night, you may get a time where they'll skip the feed, and you may get a five to six hour break at night. Every baby is different

Dawn Davenport  15:37  
wish upon you kiss the ground that baby walks on when you get

Speaker 2  15:40  
it right. At first you think something's wrong, like why is the baby not waking to eat, and you throw in there and you period you think everything's good, they're freezing, they're just really not hungry yet. But some babies keep in mind, not every baby does that. And it can be very different from baby to baby, some babies will wake up every three hours to eat, or up to six months. And even beyond that, because at some point, it can become a habit for them to wake up for that feed not necessarily for nutrition, but something for comfort and something they're looking for. So every baby will be different. These are all rules of thumb. But if your baby's not doing exactly that, it just might be that they have a different need or an emotional need, or they really are hungry every three hours. And they do want. And in that case, you could try to increase their feed volume at certain night feeds in order to try to get them through a longer period at night, if they'll take it.

Dawn Davenport  16:30  
I don't know if this was the American Pediatric Association. But I have heard of pediatricians recommending that parents wake their babies every three hours at night to feed them. And obviously, if you have a premature baby, a small baby, a baby who is not gaining weight, or any problem, that's a different issue. But this is for perfectly healthy babies, which I must say always seemed absolutely nuts to me. But

Speaker 2  16:55  
yeah, I wouldn't really recommend it. Like you said, if everything is going well, it's a healthy, full term baby gaining weight appropriately, you're really kind of feeding on cue for them at that age. But you can't really spoil a baby at that age, either. If they're waking and crying, they need something they're too young to cry it out at that age. And typically, it's usually food or a diaper change. And sometimes it's just comfort and company and they want to feel and smell you and eat near you feel that warmth. But you know, at that younger age, even six months and below, you know, they can continue to wake up every three hours. And then they will have these growth periods when babies have growth spurts, it also means that they need to take in more calories because they're gaining weight, they're getting bigger. And they're telling you and you know, the usual two ounces or three ounces that you're feeding me is not enough to sustain the big growth spurt I'm about to have right just had. And when growth spurts happen, you will notice that they'll be more cranky, crying more waking up more, waking up all night keeping you up all night feeding. And that's because they're trying to communicate to you that they just need more. So when you if it's a growth spurt time, which usually happens around two months, four months, six months, then you may recognize that that is a time where they just need more volume. And you might have to try to play around with your feet times and your volume times to get them comfortable and satiated where they're at. And instead of going three ounces, you might try four ounces and going so far. So you may have to make some work for him and let in the morning.

Dawn Davenport  18:20  
So other feeding options that adoptive parents sometimes utilize, one is induced lactation to breastfeed and another one is using donated breast milk. So let's talk a little bit about do you have any thoughts on trying to induce lactation I will say that as far as I know, the vast majority of women are not going to unless they have breastfed previously, are not going to be able to produce enough milk but they can sometimes produce some milk and there are also systems where you can have formula being fed through a tube attached to your breast. So let's talk about first induced lactation and then donate a breast milk.

Speaker 2  18:59  
Sure, so I'm not a idlc, a lactation consultant and I have training in lactation. But I will say that these are wonderful, excellent options for feeding an adoptive baby that comes into your household. So to induce lactation, you really do need to talk to two people before you even think about starting that would be your OB about sometimes they can start some hormonal medications to try to get your body ready to try to produce that lactate a little bit. And then also your lactation consultant, you should be able to find one through your pediatrician through your hospital you can find like there's lots of locations usually local, there's a national database, you'd want to talk to a lactation consultant about going through unilateral Genesis. So they will come up with a plan for you on how often you should be doing some pumping it what happens if you get something how to store it, things like that. And so definitely you have to professionals you need to get involved in that before you start it but I think it's a wonderful thing and you would be more successful if you have lactate before and breastfed A baby before you do need to be really committed to that plan, you need to hand express our pump, sometimes eight to 12 times a day to try to get some in it. And it is possible that you can get some but usually unlikely to get enough to feed the baby all that they'll need. And then you can supplement with formula or donor milk. If you are thinking about inducing lactation, there are also galactagogue that you can take to increase your milk supply like fenugreek, bless this soy milk thistle are commonly used. But again, before you start any supplements, you wanna talk to your OB first and then also your lactation consultant, also doing skin to skin, you know, while you're doing some of that pumping, so if the baby is already with you in your household, and you're trying to initiate that, having the baby near you by you while you're doing the hand expressing and pumping also can help with those hormones that help produce milk. Now using an SNS, that's the supplemental nursing system that is using what looks like a feeding tube that can come over your shoulder and be taped to your nipple. And then there's a syringe at the other end that you would feed either donor milk or formula through while the baby may latch and breastfeed. And so you actually be giving the baby maybe some of the milk you're producing, if you're trying to induce your own lactation, you're also giving some of whatever's in the syringe to make sure the baby's getting enough. But you will get that closeness that bonding also that skin to skin. And sometimes babies mouths do a better job of the pump and the hand Express of getting some milk to come out. And so that's why it's a great idea to try SNS if you are committed to doing some of that pumping donor milk, you got that from a milk bank. So if you're interested in that there are national databases that you can call to find out where you can get one in your area. Sometimes you can call your local hospital or NICU many larger NICUs will have one there. Some insurances are paying for it, that is a very cutting edge thing right now. So I'm not sure about paying for it can be really expensive. And I don't condone this, but I do know it's done. Some women do it within the community. You know, when you get milk from a donor milk bank, it has been checked to make sure that there aren't any diseases or any type of contaminants, drugs or anything in it. So you do want to get your donor milk from a milk bang. That doesn't mean that every woman does. So if you you know, some of them will go to the community or ask a friend or someone who's lactating to donate as well. So there are other options that depends on your comfort level or what you're able to do based on the adoption agency or the foster agency.

Dawn Davenport  22:28  
So how do you know if your baby is getting enough food? Now you're bottle feeding so you actually know the quantity going in? So that makes it easier? But how do you know if it's enough?

Speaker 2  22:41  
So great question, it does make it a little easier when you can quantify exactly what the baby's getting. Typically it's waking, you know, we're not weighing the babies every day. But at the pediatricians visit, you want to see that the baby is growing along the growth curve, gaining consistent weight, that's a great indication that the baby's eating enough getting enough and sleeping enough. But when you feed a baby a feed if the baby wakes up an hour after the feed and acts hungry or sucks on hands shows signs of hunger, like routing, which is sticking their tongue out, sucking on a finger just successfully crying, then if they're waking up an hour after a feed, that probably means they didn't get enough to feed before and it might be time to increase your volume. So you know, that's how you kind of know it's time to give a little bit more. Now how you know you gave enough is usually they should sleep about two to three hours in between feeds, which is why if they're waking up early, that's an indication they're not getting enough, you want to see a certain amount of peas in poop. So typically, after the baby's home and being bottle fed, you want to see a minimum of about five p diapers a day, that's a minimum. So that's showing you that the baby's getting enough taking a nap. You also want that urine to be light yellow, you don't want it to be dark yellow or orange. If a baby is dehydrated, urine can also look red with blood and the diaper. Or even crystals that look like filters sugar crystals in the diaper can be an indication of dehydration or not enough feed. So if you see any of those, you'd want to increase your baby's volume or talk to your pediatrician. Babies will also be satiated after eating if you're feeding a baby an ounce and the bottle is empty and they don't seem satiated and they really want more and they're awake and it didn't console them to sleep, then maybe they need an ounce and a half that time around. So there you're looking at a lot of different physical signs to the baby, you're looking at pees and poops and that will kind of tell you if you're giving enough or you need to give more than the signs of dehydration. If you see them. That just means you need to bump it up a little bit or talk to your pediatrician if there's another issue going on.

Dawn Davenport  24:37  
So some babies spit up a lot they this is not shown they just do it naturally. It's not a sign of improper or incorrect formula. They just are spitter uppers. But it looks like a lot of milk sometimes when it comes out. So you think oh my gosh, they just put all that milk in now it all came out. So if your baby does spit up a lot, when should you worry that they aren't getting enough? A great question and

Speaker 2  25:01  
one I struggle with on a personal level, I had a little one who was born at five pounds and had very bad reflux for the first two years of his life. And he stood up five to eight times a day required me to feed him extra, he would spit up and then be hungry afterwards, because he just fed up everything he ate. So when babies especially premature babies, or even babies who might have some medical issues, most babies even full term babies, we all have a sphincter that in our esophagus that keeps the food down there. So when we swallow, it opens up, and then it closes to keep the food down. But in a baby, it doesn't close all the way it's open a little bit. That's why babies fit up so easier when you lay them down, the food comes back up a lot easier. So it is good to try to make sure you burp a baby sitting on and then even keep them up a little bit after a feast so you don't lay them flat down in the formula doesn't come right back up the esophagus. Now that things are tightens over time, as they get bigger gain weight gain, musculature, that sphincter will tighten, and in some babies, it doesn't. And those babies can be reflexive babies, which means that spinning up can continue beyond two for six months and even a year, because I think you're maybe open a little bit or there could be another reason why they have reflux, when you will be concerned is when they're not gaining weight. So if they're spinning up after every feed that can happen for some babies, but they still may gain weight. Despite that it may look like more than they're actually getting up and they may be getting enough calories to gain weight. So you'd be concerned if you're talking to your pediatrician about all this spitting up. And then they're also showing that your weight gain has tapered off or even lost some weight, that would be a sign of concern. And you would want to do some more possibly imaging or medication or formula changing at that time. And then of course, if they're spinning up a lot, and they are having other signs of other worry signs signs of dehydration, like I mentioned before with the dry diapers or concentrated diapers, if they are spinning up across the room. So mostly babies when they spit up a blood out of their mouth or out of their nose and it just kind of dribbles down and it gets a little over you. If they spit up and it shoots across the room that is a forceful vomit and it's not normal. So that would be something you would want to have evaluated. But a blob up out of the mouth and the nose spit up after every fee, as long as they seem to be able to manage it, okay, and you're able to clean it up. And sometimes they're hungry afterwards, that's usually a normal spit up.

Dawn Davenport  27:20  
We had one we called Mount Vesuvius, he, after every meal, everything up until a certain age and then of course it's not.

Speaker 2  27:28  
And keep in mind, that's going to create a lot of laundry for you. So if you have one of those babies, that just happens to be a reflux E or a spit or upper. That is the baby, you're going to need an extra carseat cover extra Fred covers, you're gonna need some extra proof. Plus, you need to bring extra outfits for you and the baby, everywhere you go, you will go through everything you think you bring with you. So that is a baby, just bring extra for and just get a really good wash. So because you'll be doing laundry every day,

Dawn Davenport  27:59  
and it won't last forever, or at least. But for Yeah, for mine,

Speaker 2  28:02  
my Sunday went for longer than normal. But typically it resolves. You know, by a year of life, it does get better. That is a very hard time to go through. You feel bad for the baby, you feel bad for you and all your laundry. But it does get better in time. If you get to be about a year and it's still occurring. And they're walking and eating food and still vomiting that much then you may want to talk to your pediatrician about seeing a GI specialist. But definitely if it's shooting across the room, that's not normal, if it has blood in it. If it's green, those are abnormal vomits and you would want to talk to your pediatrician.

Dawn Davenport  28:33  
So what is the current thinking on where to introduce solid foods?

Speaker 2  28:38  
American Academy of Pediatrics recommends to wait as close to six months to start eating solid foods but with a pediatrician guidance. Sometimes we will recommend starting as early as four to five months with certain signs in place meaning the baby really should be tracking food when you bring it from the plate to you to your mouth watching it. Raking they should try to be able to rake with their fingers things towards them, they should try to be able to sit up on assisted so when they're meeting some of these milestones, then they may show food readiness. But definitely if it's before six months of age, you would want to talk to your pediatrician before you implement that. All right.

Dawn Davenport  29:18  
Let me pause a minute to ask you Have you subscribed yet to our free monthly newsletter. If you go to Bitly slash talk about adoption guy today, you will get the let's talk about adoption. Talking about adoption across the different ages and stages of your child's life. It is a terrific guide and it is a terrific newsletter. So check it out at Bitly slash talk about adoption guide. that's all one word talk about adoption guide. Now we have talked about feeding. Now we're going on to the next major category and probably the one that every new parent is desperate for and that is sleep So, for sleep, let's talk about what is a typical wake sleep pattern for a newborn.

Speaker 2  30:09  
Now, it will be different for every newborn, but typically they're going to sleep an average of about 16 to 17 hours a day, which is actually pretty nice. What becomes difficult for us is they can have large wakeful periods in the middle of the night when we want to sleep. But they usually will wake up and eat every two to three hours and then sleep for an hour or two in between the feeds. And that's for the first two, three, up to about a first month, they will have a pattern like that, when they get into their second month, they can have more wakeful times and be awake more in between the feeds, but still eat about every two to three hours. And at night, they're usually getting up about, you know, every three hours or so to eat. The trick is to try to feed them in a low stimulus environments so that hopefully they're not awake and ready to party, they're awake to eat, and then they go back to sleep.

Dawn Davenport  31:01  
So when can you expect on average your baby to sleep, five to six hours. And let me just tell the new parents out there, that that is called sleeping through the night, if you got a six hour stretch, or a five hour stretches, sleeping, that's how we define sleeping through the night, you're gonna have to wait a while for your eight hours. But so when can you expect a baby to sleep five to six hours,

Speaker 2  31:25  
that's right, five to six hours is considered sleeping through the night. So if you're used to getting your eight hours of sleeping through the night be ready, that's going to be a while before it comes. But newborns Do you know do have shorter sleep cycles, they'll see for about an hour at a time. But again, they can sleep longer when they're first born, it's irregular. So like I say, these are rules of thumb as far as how often they'll wake up. But at some point, especially bottle feeding, maybe they will get into some sort of a pattern, you may be able to expect we'll see in a bottle at 11. And then we'll have another one at two or three, and then we'll have another one at six. And then at some point, you might be able to skip that two or three, one, push that 11 feed back to midnight, and then your next feed will be 6am. Hopefully that makes sense. So there are times when you'll be able to try to adjust these feeds a little bit. When they're newborn, their stomachs are very small, which is why they need to eat so frequently. And that's why this changes as they get bigger and they get older, their stomachs get bigger, they can hold a little more, it takes a little longer to digest that larger feed and so they'll stay asleep a little bit longer. When you can expect them to sleep through the night, every baby is different. Some babies will see through night as early as two months, you'll have a rare baby that will do it a little bit before that. But typically on average is about three to four months of age that you'll start getting that five to six hour block of sleep. And again, there will be a few outliers that will continue waking up every three hours or beyond six months of age.

Dawn Davenport  32:48  
Okay and is the Wake sleep cycle affected by either prematurity or neonatal abstinence syndrome?

Speaker 2  32:54  
Yes, babies with neonatal abstinence syndrome do have some disrupted sleep patterns due to their withdrawal symptoms that they can be experiencing. They can have increased irritability, some restlessness, difficulty settling them, it may take a lot longer to settle them back to sleep when they do wake up. And they can have periods of excessive crying, which can be really challenging to get them into a regular sleep routine. So that will be a challenge, you need to be ready for that and be ready to include certain comfort measures or neonatal abstinence syndrome babies like a soothing environment, a low stimuli environment. So that would be darkened blinds, white noise machine, sometimes baby massage, sometimes there's little baby heating pads that you can put with the baby. This is when you're with the baby trying to comfort the baby, and just ensuring that the baby is properly fed with good hydration and nourishment. This sometimes, like I said, they may need more food or more formula or more calories because of their increased requirements. So if they're not getting that that can cause them to feel more hungry and awake a little bit more often. So you would definitely want to make sure you're getting the right formula at the right caloric content so that they're gaining weight and feeling satiated. And that may help them stay asleep a little bit more.

Dawn Davenport  34:09  
So you've mentioned that on average, you can expect a baby to be waking every, say three hours to three hours throughout the night up until maybe around eight weeks, two months, whatever, something along those lines. At what point can you start trying to get your baby to not wake up so many times for that feeding at night? In other words, either skip that middle of the night feeding or to stretch it out and get four hours rather than two to 3am. How would you do that?

Speaker 2  34:40  
So what sleep training will again vary for each baby you'll kind of know they're ready because they may do a little bit about on their own by don't wake up for a two o'clock feed and you'll be surprised that they haven't woken yet and you'll go back to sleep and hope you get an extra hour out so you want to pay attention to their own sleep patterns. See when they are pushing it back on their own. And when that happens, keep in mind, if you were normally feeding your baby at 11, then you had a two o'clock feed. And then you had, again, you know, another 5am or 6am feed, your goal is to try to cut out that 2am feed. So you may start pushing your 11 o'clock feed back to 1130 and give a little bit more in the bottle. Because that might push that night your feed back to 3am. And eventually, you'll get that last feed, so maybe midnight with a little bit more volume, and then maybe you'll be able to cut that feed out and wait until 5am For the next feed. So it's a gradual process, it's not something you would do in one night, it is something that really needs to be consistent with. So if there are multiple people up at night, doing different things that will make it a lot harder to try to get on some type of asleep feeding schedule at night. But really good communication, trying to watch the clock. So you know, if they're waking up at 11 for a feed, try to push them from actually taking it to 1130 by maybe doing some playing, doing swaddling, even like a washcloth, or something like that, to keep them busy for a half an hour and then push that feed back a half an hour. And if you do that each night, you might be able to push back that last feed, which may cut out that middle feed, and then your morning feed might have to move up a little bit. But that still may give you that five hours in between. And so you know, if you're doing this and it's not going well your baby just might not be ready for it. You know, some babies are ready at two months. But really, in my experience, it's three to four months that they're really ready to start trying to do some of those sleep training measures of some sort to try to cut out one of those night feeds.

Dawn Davenport  36:38  
Well, introducing solid foods, even if watered down, help your baby sleep through the night. The old adage was, well introduce rice cereal mixed with formula. And that added book would actually help the baby is there anything to that.

Speaker 2  36:54  
So I believe there is not any research that shows that words that is sort of a white cell that's passed on from person to person. Yep, that's how I heard about it. There is some bit of a danger. First of all, you'd really want to use oatmeal, if you're going to do that rice cereal, we're moving away from a little bit because of the rice. And that can be a toxin for babies. So we want to try to be really careful about what rice we're using. Make sure it's you know, specialized for babies. But really, we would go more towards oatmeal in there. And you have to remember that it's going to really stick in the bottle. So sometimes moms will then cut the nipple and an X pattern, which can also cause choking, if they're taking that bottle and they're not used to getting that larger opening and the nipple, it can really intake a whole bunch and cause them to have some issues with swallowing and managing that. So you want to be really careful with doing that choosing a feed like that, and a baby can be disruptive to them. And really there isn't any data that I'm aware of that really causes them to sleep longer. Some moms will do this at four months. But if you're introducing food, it can cause some issues with the gut if the gut is not ready to accept food yet, and to digest those types of proteins yet. And with gut health and gut flora being so important, we don't really want to disrupt that until we're really ready that the gut is ready to take that. So I will usually say No, I think if your baby's ready to actually eat oatmeal from a spoon, I would be that to the baby from a spoon you may even consider doing. If your baby sitting up at five, six months doing that then maybe save a little bit of a feed like later on at night. But I wouldn't really put it in the bottle, I would keep the bottle just formula or breast milk.

Dawn Davenport  38:28  
Something we should have started with didn't even think about this. To begin the recommendations now are that you place the baby on their back, no pillows, no blankets, no bumpers, no stuffed animals in the bed. And I think that recommendation especially the sleeping on the back continues until the baby is rolling over on their own and when they're rolling over on their own, then I think there's less concern because at that point the baby can pick it set up anything else that I missed on the basic standards of how we get our kiddos to sleep.

Speaker 2  38:59  
Right so you're describing safely practices American Academy of Pediatrics and to reduce the risk of SIDS, SIDS, sudden infant death syndrome where a baby can spontaneously suddenly die up to a year of age. So your risk doesn't end at six months. Your risk for SIDS goes on to the first year. So you do want to continue safe sleep practices for the year. And that is laying baby on the back. You don't have to stand over there and watch them and see if they roll over that you have to pop them back over once they can roll over on their own. It's okay to let them sleep in the comfortable position that they want to be in. As long as there was no pillows we really suggest no blankets, no stuffed animals in the bed. No crib bumpers, those are really not recommended. But yes back to sleep for babies. If you have a baby with reflux, your pediatrician may tell you to elevate the crib, you need to follow their recommendations on how to do that because that can also increase the risk of SIDS. But sometimes they will recommend you do that for your baby because of the risk of reflux. So sometimes we will tell you to do something different than safe sleep because we need you to do that for another reason but on a regular basis. This your baby should be on a flat surface with nothing else in the crib, baby should sleep in the room with you, but in a different sleeping surface for at least the first six months and really American Academy of Pediatrics recommends for the first year. So we asked, we have these nurseries and we want them in their own room. But really, it's recommended that at least for the first six months, they should be in the room with you and methods for reducing SIDS risk. It is very dangerous for you to sleep with the baby on a couch and armchair or a nursing pillow because that is when they're in our deep sleep. And we're usually overtired. And we think we're going to wake up when something happens. But because we're so low honestly, when we finally do fall asleep, it is difficult for us to wake up and we may not wake up when something is wrong with the baby, meaning the baby falls into the couch cushions. That is a very common way for babies to suffocate is on couches, when moms are breastfeeding and couches trying to get the baby away from someone else who's sleeping in the same room that that person can sleep and then they fall asleep at the baby on the couch. So do not do that that's not good on the couch. So babies should be fed and then put back onto their own service. But in the same room as you sew a crib in the room with you or some type of piece of baby furniture that's near your bed so you can check on the baby.

Dawn Davenport  41:12  
Let me quickly tell you about another resource from creating a family. It is our interactive training support curriculum for foster adoptive and kinship parents. It's meant for trainings, each one will give you 1.5 hours worth of training. They also can be used for topics to discuss as a support group, we have a curriculum library of 25 curricula for you to choose from. They are intended to be an all in one curriculum designed to make it as easy as possible to run a high quality training or support group, check it out at parent support that parent support Or you can go to the creating a family website, hover over the horizontal menu that says training and click on Support Group curriculum. Alright, so now we've already talked about two of the high points, feeding and sleeping now it's time for poop. So how often should babies poop? So what's normal, and again, that I realized that varies by age. So kind of break it up age wise.

Speaker 2  42:19  
Yep, every baby's going to be different, you'll have some babies that will poop once or twice a day. And some babies will poop every single time you change the diaper. You know, if you're having more than 10 poops a day, and or they are very watery or liquid and so watery, that they're almost soaking into the diaper and not laying on top of the diaper. That's a sign of diarrhea. And that needs to be evaluated by a pediatrician or even possibly the hospital because they can get dehydrated very fast if they have diarrhea. So a 10 or more stools or a very watery stool that soaking into the diaper is not a normal stool, or a baby that's going three or more days without a stool that's considered constipation. And so you would want to talk to your pediatrician about measures that you can take to help them with the conservation and then going forward to prevent that. But really, there's a lot of normal in between that. So some babies may poop once or twice. Some babies may poop five times a day, who consistency can be very soft can be grainy looking formula poop in the very first couple of weeks of life is usually a very yellowish, grainy, soft stool. But if your baby has very hard nuggets in the diaper, that also might be some type of constipation stool that you can talk to your peers. Typically, I'll tell you to maybe start with some prune juice in every bottle. Rather than don't feed a bottle of burn juice, you would put like a tablespoon or two in every formula bottle that you make, to try to help things move along. So if your baby's having some harder stools, or skipping a day or two without having them, once you get things moving the prune juice isn't really a treatment, it's more of a preventative.

Dawn Davenport  43:54  
All right. So what type of diaper is best? What are our options? Obviously we've got cloth or disposable and really with disposable Is there much difference between the different brands. So let's start off with cloth versus disposable. And then let's talk about disposable options.

Speaker 2  44:10  
So a lot of that is apparent preference and asked to go with you know, financial preference, environmental concerns. A lot of people prefer the cloth because they're not throwing out so many diapers and landfills and they can wash but they can be very expensive in the beginning buying them. Really diapers are going to be expensive either way that you go. So it's your preference whether or not you want to be washing a washable diaper or throwing it out over here. So that's a personal preference. I don't usually make a recommendation on that a mom will decide but if you go with cloth, I'd always have a couple of extra disposable around just in case. You don't have one that's clean or you run out you have backup. As far as branded diapers again, many of them are very similar, but some people who have babies with really really sensitive skin really liked the honest diapers, but I don't really find much difference in brand as far as comfort for a baby, but you will have some that believe one will absorb better than the other. I personally am a pampers girl. I think the price is great. I feel like there are leaks are very minimal. And for most average babies without major skin problems or anything like that, they usually are fine. I think it's more important to pay attention to the wipes that you're using. So if you're having a baby with sensitive, but you would want to make sure you're using a sensitive wipe with no sense no dyes and that because many times it's not the diaper that they have an issue with. It's the white.

Dawn Davenport  45:35  
That's a really good point we asked him we think about the diaper, but often it's the wipe that is causing, especially drying out the baby's skin. Yeah. How do you treat? Well, first of all, how do you know if a baby has diaper rash? It sounds obvious, but let's go ahead and ask that. How do you know if a baby has diaper rash? And what should you use to treat it? And when should you start applying the cream or whatever?

Speaker 2  46:00  
One of my favorite questions. So it's something I talk about a lot to my postpartum clients and my hospital clients. You don't really need to use a preventative diaper rash cream on a baby's butt unless you start to see a rash. Now keep in mind, a rash is going to start to usually start out looking a little red on the skin. So the buttocks should really look flesh colored. If anything around the buttocks or around the anus or around the labia or scrotum are looking red or angry looking, then you have the beginnings of a rash and you want to start coding it to protect it. Keep in mind if you have a neonatal abstinence syndrome baby, they are at increased risk for severe diaper rash, because many times they will have diarrhea and very acidic stools going on. And that will create very, very terrible diaper rashes. And it's through my work with those types of patients that I discovered a diaper rash cream called tal mo 17 CALMOSSEPT ind, you can get it over the counter. It sounds really fancy. But you can get it on Amazon, you can get it at your drugstore. It's a green and white labeled tube. I usually tell people to order the double one on Amazon, I think it's like $14 Totally worth it. You can take your destination and throw it right out in the garbage. It's what I tell everybody Dustin really does not work. A lot of people have a lot of other home remedies and different things that work. But I've been doing this for 20 years and I've never seen anything work as fast on a diaper rash is almost 15 And basically you will start using that on any buttock or at bottom area that starts looking red. If the skin is already breaking and bleeding, then that's a beyond rash that's already been going on for a day or two. And you also want to make sure you're changing the diaper at least eight to 12 times a day. If it's a newborn, every time you feed that baby you should be changing the diapers to keep that wetness away from that area. So kalma cepting knew to start using and you will notice a difference in the baby's diaper rash, almost a very next diaper change. Diaper rash is on notoriously known for hanging on and going on for days and days baby scream and it really awful to watch them go through it. But there's nothing like that product out there. And we do use it in the NICU on our unit abstinence babies, and it's something I really really tell parents about it's like a best kept secret. So

Dawn Davenport  48:15  
that's great. Well add that to our tip section. So how can you tell the difference between a regular diaper rash and a yeast diaper rash and is the treatment the same?

Speaker 2  48:27  
So a yeast Diaper rash is typically going to be a very angry red large area over the baby's perineum area and sometimes extending onto the thighs and sometimes it will have a raised pap you will look to it and just be very angry and read if you see a large papule red rash you would want to talk to your pediatrician because if it is yeast, then it will not be treatable by something like homocysteine you would need a prescription nice statin cream for that and then the baby should be evaluated over the whole body including the mouth because sometimes if they have yeast infection down below, they may have these infection in the mouth and also need oral Neistat.

Dawn Davenport  49:07  
Okay. Now, as you promised at the beginning, we're going to talk about colic. I think a lot of parents dread colic, understandably, it is not pleasant for the child nor the parent. So what is colic? And how do we treat it? Typically, colic episodes

Speaker 2  49:23  
are mostly very long crying episodes that are usually worse that night. They can be really random and not associated with feedings so when you have a baby with colic many times you're trying to figure out is it reflux or is it colic because they can mimic each other and look very, very similar. So it's really important when you go to your pediatrician because they're only going to see you and your baby for 10 or 15 minutes and in order for them to really figure out what's going on and guide you you need to come up with a really good history so keep a little log on what's going on because just saying to the doctor I think they made this colicky. You really want to get the proper diagnosis because in order to fix it, you Get the right treatment. So to be sure it's colic, you know, they usually will have a lot of crying episodes that can be worse at night, it can be very random. Like if it's reflux, it's usually associated with right after feeding because their bellies are full and they're going to spit up and they feel that reflux pain or that acid burn, and so they're usually going to scream and cry after feeds, but a colicky baby will not usually do it around feeds, it's random, it could be around these, it could be nowhere near a feed. And so that is a big Hallmark difference between reflux and colic cries, they usually will have a normal desire to eat, and many times they'll be gaining weight and growing just fine, which can be hard because the foster parent will take the baby and the pediatrician says everything's fine the baby's growing on the curve, but the parent just feels like something is off something is wrong is the baby is crying a lot. Now, a colicky baby will have a lot of body tension, they will pull up their legs, they'll stiffen their arms, they'll clench their fists, they can arch their back, their bellies can get a little tense and hard, and they will just have intense crying that seems like they're screaming or even more, it's an expression of pain. We're not really sure exactly what causes colic, there's a lot of ideas and many people feel it has to do with gut some people feel it has to do with Mal alignment. And some people will suggest getting a chiropractic adjustment. You know, I don't make those medical recommendations. That's an idea to talk to your pediatrician. But some people will try different things when it's called, like just people will try anything because it's so hard to watch the baby go through that and very exhausting to have a colicky baby, but I can go over some tips for managing it. So if you feel like your baby has colic or your pediatrician, and you have realized that there isn't another medical reason for your babies do, you want to make sure you talk to your pediatrician to make sure there's no other medical reason for the crying. And once things have been ruled out, and it's really just diagnosis calling, you would just manage it and just need to keep in mind that it will get better they do grow out of it. And you have to just try to do measures to try to get through those crying bouts. A lot of parents really feel like a warm compress, like a little heating pad over their bellies may work. baby massage is a great thing to learn. There's a lot of videos out there to do it, you lay the baby down across your lap or somewhere nearby and you do massage over certain parts of their body. I really love bicycle legs. Bicycle legs are when you move there lay the baby on their back and you move their legs in a bicycle like motion. But when people usually do it wrong, because they just gently move the length in a bicycle rotation, you really want to push those thighs up into the lower abdomen. So you're really doing a very large bicycle ride and you're kind of using those legs to kind of massage that lower belly, and that will help sometimes my lecan drops can help. A lot of parents really swear by putting the baby in a warm bath during these times. Now some babies hate baths but if your baby's a bad lover, and they're having a colic episode, a warm bath can help making sure your baby is burping after every feed. That's an important skill that you will learn after you have your baby home is how to best burp your baby. So make sure you're getting the burps out. Sometimes colicky babies really love baby wearing sometimes just being with you and on you will help comfort them and sometimes that won't help at all. But if it does, and your baby is one of the ones that snuggling will help a baby wearing time or a baby wearing sling can help that baby just feel close and protected and comforted and keep that baby feeling tight like they're still back in the womb and may help them same thing why swaddling will work so it's another great skill as a new parent taking home a baby is to learn how to swaddle a baby. It's one that I teach in my course it's very important. Also, using things like white noise. taking them out on car rides is a very classic one that will sometimes help low them to sleep and get out of that colic episode, putting them on tummy time. So tummy time is when you just put them on their belly, some will hate it, some will love it. These are all different tips that you'll have to try and just kind of figure out what pieces of this puzzle were work for your little one. Sometimes a pacifier will help soothe and comfort them. Babies do suck to comfort themselves. It's a natural reflex for about the first two months to try to pacify themselves to sleep and for comfort in so many use cases, you would try a pacifier to see if that will help as well. All right,

Dawn Davenport  54:17  
this one doesn't fit under any of the feeding, sleeping are pooping, but what is the current thinking on circumcision?

Speaker 2  54:26  
Right so circumcision is a very controversial issue. And the reason for that there really is currently no medical indication for getting a circumcision. So there are religious practices that will usually suggest doing a circumcision and then there are also personal preferences on body autonomy for the infant and allowing the baby to make a decision on that on their own rather than making it for them. So a decision on circumcision is very family oriented depending on religion, what has been done in the past in the family And what your beliefs are for your baby's choices and body autonomy. So we don't recommend it. It's a personal choice. If a parent wants it, then we teach you, you know how to treat it afterwards, my current thinking if somebody doesn't know if they want to do it or not, I usually say don't because you can't go back and change your mind after it's done. But you can always decide later on or the child can they want to do it later. Even if that surgery might be a little bit more complicated. It's really one of those surgeries, you can't reverse or easily without plastics involved. And so if you're really unsure, then I would say, Wait, but it's definitely a conversation with your pediatrician and your obstetrician. And most states, it's the obstetricians that actually do that procedure. So that would be someone that would be a great person to get involved in that conversation. Okay, good.

Dawn Davenport  55:54  
I hope you're enjoying this conversation about baby care. It is a topic I absolutely love to talk about. But if you appreciate this content, you will be happy to hear about the free courses we offer at Bitly. Slash JBf. Support. And our partners, the jockey being Family Foundation, are sponsoring a library of courses to support you in building a strong healthy family. Check it out today at Bitly. Slash j, b f support. Now we've come to the TIPS section. We've already mentioned so many the baby rash cream, say the name again, please. Oh, that

Speaker 2  56:30  
would be camo cepting CALMOSPE t i n e cow mo cepting.

Dawn Davenport  56:39  
Okay, oh, give another one you've already said. And that is, don't panic if things are not how you think they're supposed to be babies change rapidly. So if your baby is not sleeping, and you really wish this baby was just hanging in there will if your baby is not eating well, of course, that's something to check with your doctor, but that babies change and sleep will eventually come. Any other tips for new parents?

Speaker 2  57:04  
Sure. I mean, as far as your audience goes, You're we're talking to adoptive and foster parents who are getting ready to bring a newborn into your home. And I think that the best thing to do is and I think you're already aware to get as prepared as possible because it's a 24 hour job taking care of the baby. One thing I usually like to say is to get a first aid kit together to have in your home of family first aid kit is something I teach in my course I have a great list for it. And I usually say there's you know, a list of about 20 to 30 things and it's really worth it to have in a nice Tupperware or some type of kit because many times when a baby's gonna have an issue, it's always 11 or midnight, you know, in the middle of the night. And depending on where you live, you may have a 24 hour pharmacy or you may have to wait till the morning and that's a really long night to have to go through and you know, find that you need a suppository, or that you really could have some nasal saline. Many of these things that I suggested they cared are pretty low costs all over the counter, but really will make your life easier if you have them in the home. So I would suggest getting together a nice kit.

Dawn Davenport  58:14  
We will include that in the resources here. Your list Yes, that's a great idea. And you know, honestly, when people are saying oh, you know, register you know if you're going to have a baby registry register these things Yeah, and let people get them to you know, honestly another pair of onesies is probably not what you need. they outgrow the newborn stuff so quickly, but this family first aid kit you will keep forever

Speaker 2  58:37  
Yes, you want a good thermometer in there because that's one of the most important things for the baby's not feeling well is to make sure you know the baby's temperature many times that might be the only way they display that something is wrong. So having a great thermometer in the house is one of the main things baby Tylenol baby Motrin again don't give them to a baby under six months without your pediatrician being aware and you'll need to call them for the doses for those anyway but just having them there. Another tip that's really important for you know a family taking home a newborn is to you know, take some time to get to know your baby gear. It's really shocking how confusing some of these things can be. I remember trying to set up my Diaper Genie and having to watch three YouTube videos and feeling like I was a complete idiot not figuring out how to just fill up the Diaper Genie I mean and when your baby's crying or you need this equipment for something it's really stressful trying to learn it while they need you for something

Dawn Davenport  59:29  
baby wraps the same way figure out how those Rambo be rap.

Speaker 2  59:32  
Yes, watch our videos. Yeah, and so great. Now, back in the day, we didn't have things like YouTube now we have YouTube so there's so many resources available right at our fingertips. But the most important thing would be your Carsey making sure that your Carsey is set for the baby's weight and age. So you need your car seat manual. You should always keep your car seat manual with your car seat. Most car seats have a little spot for it underneath. You may not realize it but there's a little spot to keep the manual and then you would want to make sure your base is attached in your car properly. And you should really have it checked by someone who does carseat checks usually at your police department or your fire department, they'll have certified people who can check to make sure it's installed properly. So so so many car accidents will happen where babies are injured or are dying. And it's mostly 80% of them don't have the seats installed, right or the baby in this seat properly, where it's set for the baby's weight and age. So really read those books really front and back, get to know your carseat know, also as the baby grows, when it's appropriate to adjust those straps to make sure that they are fitting the baby properly. So that is a major, major safety one, and one that you don't want to be fiddling with on the day of discharge when you have so many things thrown at you and instructions. And now, you've still got to figure out how to work your car seats. So that is something you'd want to make sure you do ahead of time. Let me see. I'm trying to think if there were any other major tips that you know that baby's birthday kid, choosing a pediatrician is really important. But many times in your clients cases, they may have a pediatrician assigned to them. So just making sure you have their contact information, you know how to reach them in an emergency. Also really good to know where your nearest Children's Hospital is. A lot of new parents don't realize that when your baby has an issue, they'll just take the baby to the first hospital that's nearest to where their houses, but many times it these are smaller community hospitals, they aren't trained or they don't have pediatric ers. And many times your babies will then be transferred from that hospital to another Children's Hospital. And that can be wasted time. And so if you're driving your child to the hospital for some reason, and you have the time to make a little bit of a longer trip to a children's hospital, that's where you really want to take an infant or a young child is right to a place where there is a children's er and a children's hospital, you will get the best care you will get the specialists, you will not have wasted time they will be able to take care of any testing that needs to be done. And it's just going to be a better experience all around. So a lot of people don't know that. So if you end up in the hospital for some reason, go to a children's hospital.

Dawn Davenport  1:02:05  
Great point. Well, thank you so much Christine Odell for being with us today to talk about the basics of baby care we truly appreciate.

Speaker 2  1:02:15  
Thank you so much for having me today. It was a lot of fun and I hope I was able to give some value to your listeners today

Dawn Davenport  1:02:22  
you have today I want to tell you about one of our oldest partners and that is children's connection. They have been on from almost the beginning of this podcast and supporting our mission. Children's connection is an adoption agency providing services for domestic infant adoption and embryo donation and adoption throughout the US. They also provide home studies and post adoption support to families in Texas.

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