Class 1 - Preparing for Your Baby

Educating Yourself

No matter how proficient you are in your job or life in general, the idea of caring for a baby puts most people far outside their comfort zone. Your prior experience is minimal or nothing, and the stakes are high! Naturally, pregnant couples want to educate themselves ahead of time, but it can be very difficult to navigate all the information thrown at you. There’s a seemingly endless list of must-read books, must-take newborn care classes, or must-follow advice from friends and family. What’s more, much of the information is conflicting from one source to the next, and it’s hard to know which guidance to trust.

Newborn Prep Classes

Additional Education

Products You Need and Those You Don't

About a minute after your home pregnancy test turns positive, the marketing onslaught begins. To be fair, it’s very good marketing. Every product is a must-have, and the messaging suggests you and your baby’s sleep/development/nutrition/whatever depends on you forking over your money. As they look at the endless baby clutter around their living rooms, most parents I work with wish they’d been more selective, and put that money in the college fund instead!

The Sleep Environment

In order to prevent sudden infant death syndrome (SIDS), your baby’s sleep environment (daytime and nighttime) needs to be safe. Provided your options are all firm and flat, with no more than a 10º incline, you can focus on the next most important aspects, like price and space.

What to Buy

  • We recommend a bedside bassinet or a play yard (portable crib).
  • Bedside Bassinet
    • Designed to offer easy access to your baby for breastfeeding at night.
    • They are safe for sleep, less expensive, make breastfeeding easier, and take up less room.
    • The Arm’s Reach Clear-Vue is a great option we love.
  • Play Yard
    • A play yard is a portable crib
    • Your baby will outgrow the bedside bassinet around 5 months or earlier
    • A play yard is a safe, portable, inexpensive option that will take you well beyond 12 months of life.
    • We suggest the Graco Pack N Play
  • Cribs
    • Although attractive, full-sized cribs take up a lot of space, are difficult to assemble and disassemble, and are ultimately unnecessary given the bassinet and play yard options that exist.
    • Regardless of your preferences, cribs are safe for infant sleep, and that's really all that matters.

What Not to Buy

  • In-Bed Sleepers
    • In-bed "sleepers" are designed to be placed in bed with you.
    • Common examples include:
    • We strongly recommend against buying these products for several reasons:
      • Despite being called "sleepers," they are not safe for sleep.
      • They aren’t subject to the safety standards put forth by the AAP and tested by the Consumer Product Safety Commission (CPSC). For this reason, they are not a safe place for your baby to sleep.
      • With prolonged use, they cause head flattening in your baby compared to firm and flat sleep environments.
      • The bedside bassinets discussed above provide the same benefit of easy access for breastfeeding without increasing the risk of SIDS.
  • Swings, Rockers, Bouncers, Floor Chairs
    • These products place your baby at an incline, and are designed to offer caregivers an opportunity for hands-free time from baby.
    • Common examples include:
    • We recommend against buying these products for several reasons:
      • With prolonged use, they delay motor development. 
      • With prolonged use, they cause positional head-flattening, a.k.a. plagiocephaly.
        • This often requires physical therapy and sometimes an orthotic helmet to correct.
          • The helmets are expensive, and, as a cosmetic therapy, are rarely covered by insurance.
        • Our pediatric physical therapy colleagues routinely recommend parents remove all “containers” such as these from the home altogether.
          • The beginning of their medical notes usually begin with a list of these “containers” in which the baby spends significant amounts of time at the home.
      • They are unsafe for sleeping, and many babies fall asleep in them for periods of time without parents noticing right away.
      • When awake and happy, your baby is much better served doing tummy time, for gross and fine motor development. Tummy time reduces the risk of head flattening as well.
      • When you need a break, and you’re all tummy-timed out, your baby will be perfectly safe and happy on a firm, flat surface like the bassinet or a play yard.
  • The Snoo ($1,400)
    • This is a hard one because some parents swear by the Snoo.
    • Despite the bells, whistles, and amazon reviews, in reality, the Snoo is simply a $1,400 bassinet, and nothing more.
    • The sleep guidance we offer will help your baby sleep in any safe environment.

Newborn Medicine Cabinet

Having important treatments and medicines on hand can save you a trip to the store when your baby is suffering and stress is high.

Rectal Thermometer

  • Please read our guides for all the information you need:
  • If your child has a true fever (over 100.3º F, or below 97º F) in the first 90 days of life, it's important you let us know right away.
  • Given the importance of a fever in these first 90 days, we must be certain your reading is correct.
  • A rectal temperature is the only temperature we know we can trust.
  • Our recommendation:

Fever and Pain Medications

Vitamins

  • Mom should continue her daily prenatal vitamin for as long as she is breastfeeding.
    • Nature Made is a good option, but whichever option you took during pregnancy will be just fine as well
  • Babies need a daily supplement of vitamin D (not well-transmitted in the breast milk) for bone growth and development.
  • Starting at 4 months of life, babies should be started on a daily liquid iron supplement, in addition to continuing vitamin D.

Runny Nose & Congestion

  • In rare cases, your baby's runny nose or congestion will prevent them from eating or sleeping.
    • In these situations, we recommend using a nasal aspirator.
    • If your baby's congestion and runny nose are NOT preventing them from eating or sleeping, we recommend parents ignore these symptoms to avoid irritating the sensitive mucosal lining of the nose with the aspirator.
  • There is good data that a cool mist humidifier can add moisture to a sick child's dry respiratory secretions to help them cough it from the lungs.

Diaper Rash Treatment

  • Many babies develop irritation on their fanny cheeks from contact with the diaper contents.
    • This usually starts as vertical red streaks where the cheeks contact each other and the diaper surface. 
    • Without proper treatment the skin can break down further
  • In order to prevent this from happening, or as soon as the early redness develops, it's important to use a barrier cream that also helps rebuild the broken skin.
    • We recommend applying it with every diaper change "like you're frosting a cake."
    • Whichever diaper rash cream you use, be certain it contains 40% zinc oxide.
    • One good trick is to apply a very thin layer of petroleum jelly to the lining of the diaper to keep the rash cream from absorbing into the diaper.
    • A plastic spatula make applying diaper rash cream much easier, provided you're certain to get into all the nooks and crannies.

Miscellaneous

  • Nail File
    • We do not recommend a nail clipper for use on babies, because of how common it is for parents to accidentally clip the skin.
  • Gauze Pads
    • Gauze pads provide a sterile option for skin cleaning (such as around the eye) and protection (on the penis after a circumcision, for example). It's always good to have some on hand.
  • Circumcision Care
    • The same jelly used for diaper rashes helps aid penis healing after a circumcision.
    • Apply the jelly to fresh gauze, and cover the penis after each diaper change.

Cord Blood Banking

Cord blood is an incredible source of stem cells which can be used to treat infants and older children with fatal diseases including cancer, blood disorders, immune deficiencies, and metabolic disorders. Cord blood is taken from the placenta of healthy newborns, and does not interfere with the labor or delivery process. Cord blood can be banked publicly for free, or privately by for-profit organizations.

Public Cord Blood Banking

  • At Modern Pediatrics, we recommend you consider public cord blood banking for the following reasons:
    • It is free of charge, and your delivery hospital or midwife can facilitate the process for you.
    • It increases the donor pool for infants and children with fatal diseases.
    • There is government oversight in the process of collection and storage to ensure the donation will be effective.
    • Public cord blood is used more than 30 times more often than privately banked cord blood.

Private Cord Blood Banking

  • We recommend against private cord blood banking for the following reasons:
    • Private banking is expensive: $1,350-$2,300 placement fee, plus an annual maintenance fee of $100-$175.
    • Unless there is a strong family history of serious diseases in children, it is unlikely you will ever use the cord blood.