Irvine Family Practice Medical Group The Newborn to 4 months



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Irvine Family Practice Medical Group

The Newborn to 4 months

Feeding

  • Research has shown that breast milk is the best food for your baby, providing the most easily digestible and complete form of nutrition as well as protective immunity factors from mother to infant.

  • Breast feed on demand, allowing the baby to dictate when and how long to nurse. The average infant feeds approximately 10 minutes per breast every 3-4 hours.

  • If you choose to feed with formula use a preparation with iron. Low iron formulas have inadequate amounts of iron and can result in anemia. Feed your baby 2-3 oz. every 3-4 hours.(approximately 3 oz./ lb./ day ) By two months of age feed about 4-6 ounces every 4 hours.

  • By 2-3 months, the typical baby will feed 4-5 times in 24 hours.

  • Never warm bottles in the microwave.

  • Never give your baby honey in the first year of life.


Being a Mom and Dad

  • You cannot spoil a newborn baby. Remember, a baby’s only means of communication is through crying. Studies suggest that newborns who are held often and spoken to can become easier to pacify in later life and tend to cry less.

  • Never shake or spank your baby, you can cause serious injury and death.

  • Never leave your baby alone on a bed, sofa or table. Always stabilize the baby with one hand.

  • Never leave the baby alone in the tub-a newborn infant can drown in one inch of water.

  • Use a car seat for every car ride and remember the baby must ride facing backward until one year of age. Car seats cannot be used with passenger-side airbags.

  • Wash your hands with soap and warm water for 10 seconds prior to handling the baby and insist the same for family and friends. Keep the baby away from crowds and sick people. These simple precautions can prevent a long and difficult night in the emergency room.

  • Have a thermometer at home.

  • Rectal temperature over 100.4º,oral temperature over 101.4, or axillary (armpit) temperature over 99.4, poor feeding, vomiting or frequent coughing may mean your child is sick. Call your doctor or the doctor on-call immediately.


Crying

  • Babies can cry 1-4 hours a day.

  • Look for causes such as hunger, pain, temperature, dirty diapers, fatigue. However, some babies cry for no reason at all.

  • Babies do not cry to manipulate their parents or because they do not like them.

  • If having a difficult time consoling your baby try rocking in a rocking chair, gentle stroking of the head and back, singing, car rides, or even a warm bath.

  • It is natural to become frustrated or even angry during times of prolonged crying. If you do feel yourself going “over the edge” please put the baby in the crib and step away for 10 minutes to regain your composure. Call a friend or relative to help you and give you a break.

  • A baby should sleep on its back.


Irvine Family Practice Medical Group

6 months

Feeding

  • Introduce table foods, but watch out for choking. (no nuts, hard candies, hot dogs, popcorn, grapes, etc.).

  • Start with cereal, vegetables(yellow-green), meats (chicken-turkey-beef) and fruit last. All foods must be carefully prepared to avoid choking-soft and small.

  • Most babies will eat 2-3 meals per day.

  • Try new foods every 3-4 days and watch for problems such as as diarrhea, rash, etc.

  • If not breast feeding, use formula with iron (never low iron).

  • Let your baby decide how much to eat.

Parenting

  • Use sunscreen for sun exposure.

  • Have Poison Control Center (1-800-222-1222) near the phone. Do not use ipecac syrup. Formerly recommended, it is not to be used to promote vomiting since studies have shown it can cause more harm than good.

  • Do not put a baby to bed with a bottle.

  • Clean your baby’s teeth with a damp washcloth after meals. Do not use fluoride-based toothpaste until at least 2 years of age.

  • Child-proofing: Do not keep medications in your purse. Have visitors keep their purses out of reach.

  • Remove bumper pads and crib gyms.

  • Put safety gates at top and bottom of stairs.

  • Watch your baby at all times around all water(pools, hot tubs, buckets)

  • Play games like peek-a-boo.

  • Let your baby play in a safe place on the floor or playpen.

  • Read books to your baby every day.

  • When disciplining your child firmly say “no” then point out the problem. Never yell at nor spank a baby.

  • No television until the child is 2 years old. Television viewing in the young child is associated with Attention Deficit Hyperactive Disorder (ADHD)

Child-Proofing Checklist

  • Keep medications, alcohol, cleansers, and other poisons in a locked cabinet, out of sight.

  • Use child-proof window locks and guards of all windows above the first floor.

  • Don’t allow telephone and electrical cords to dangle within a child’s reach.

  • Hang drapery cords or blinds out of reach.

  • Unplug appliances when not in use.

  • Use safety plugs is all unused outlets.

  • Install safety latches on bathroom and kitchen cabinets, and toilet lids.

  • Keep bathroom doors closed.

  • Screen off fireplaces and other heat sources.

  • Safety gates at top and bottom of stairs.

  • Do not leave buckets or containers of water or other liquids on floor.

  • Hot tubs and spas should have a locked cover.

  • Water heater temperatures should be turned down to 120º or less.

  • Turn pot handles toward back of stove while cooking.

  • Avoid remodeling, drilling, sanding, or scraping walls if your house was built prior to 1960 because the paint may contain lead and lead contamination via dust particles can occur.

  • Poisonous plants should be removed. A partial list of poisonous plants include: philodendron, dieffenbachia, schefflera, azalea, ivy, pothos, rhododendron, elephant ear, narcissus, daffodil, holly, oleander, lily, foxglove, tulip, primrose, mistletoe, geranium, camation, poinsettia. If you have any question, call the poison control center.


Irvine Family Practice

12 months


Feeding

  • Now is the time to introduce whole cow’s milk to replace formula/and or breast milk. Do not feed low-fat or non-fat until at least 5 years old.

  • Do not put your child to bed with a bottle.

  • Encourage drinking from a cup.

  • The typical child eats 3 times a day plus snacks.

  • Encourage water between meals and limit juice to 1-2x/daty.

  • Allow the child to decide how much to eat.

  • Give a variety of table foods. Avoid foods that can be easily choked on; do not give nuts, hard candy, whole hot dogs, popcorn, gum, grapes, raw vegetables)

  • By 18 months of age a child should be fully weaned from a bottle and meeting all nutrition needs with table foods.



Suggested amounts

  • Whole milk: 2-3 cups per day. More than 3 replaces other foods.

  • Fruits and vegetables: 4 servings per day. 1 tablespoon per year of age per serving(a 2-year old will eat 2 tablespoons of fruit or vegetable at every meal plus a snack)

  • Grains: 4+ servings per day. Bread, cereal, rice, noodles-whole grains approximately half the time. One serving is 2-4 tablespoons, 1/4 to 1/3 slice of bread, or 2-3 crackers

  • Protein foods: 2 servings per day. Meats, fish, poultry, eggs, beans, at least 1/2 ounce per serving.



Parenting

  • Brush your child’s teeth every day. Do not use fluoride-containing toothpaste.

  • Use sunscreen before exposing the child to sun. Encourage your child to wear a hat, preferably with a wide brim.

  • Watch out for your child grabbing hot pots, curling irons, irons, cups of liqud.

  • Watch your child at all times near water. Swimming pools should be fenced from all sides and have a self-latching gate.

  • Place the child in the back seat backwards if less than 20 pounds and forward if greater than 20 pounds.

  • Hang drapery cords and electrical cords out of reach.

  • Play games, talk, sing and read to your child every day.

  • Fear of strangers is normal at this age.

  • No television until your child is 2 years old


Irvine Family Practice

18-24 months


Feeding

  • Many children eat less and are more particular in their eating.

  • Let your child decide how much to eat.

  • Give a variety of foods but watch for choking.

  • Your child should be weaned from the bottle by 18 months.

  • Give your child whole cow’s milk-not too much, however. More than 2-3 cups per day can stifle the appetite and cause anemia.



Parenting

  • Brush your child’s teeth twice a day. At two years of age you can apply a tiny “pea-sized” amount of toothpaste.

  • Go for family walks.

  • Wash your hands after changing diapers.

  • No television until 2 years of age.

  • Check carefully before backing your car ot of the driveway or a parking space. Watch for children at all times near streets or parking lots.

  • Use the car seat at all times. Never leave a child alone in the car.

  • Your child may show interest in potty training at this age.


Potty training

  • Many children are ready by 2 years of age, however, most are potty trained by 3 1/2 years.

  • Training can take 2 weeks to 2 months.

  • Staying dry at night doesn’t occur until age 3-5.

  • Your child is ready when he or she understands what “poo, pee, potty” and words of this nature.

  • The child is ready when he or she prefers dry diapers and understands that going to the potty means having a dry diaper.

  • Get a potty chair (portable and low to the ground) and rewards.

  • Make it fun-use it as a chair only for at least a week.

  • Encourage practice runs to the potty. Watch for signs of a full bladder, then encourage your child to use the potty. Never force, punish, or pressure your child to sit on the potty.

  • Praise or reward your child for any success.

  • Change your child after accidents. Don’t scold or punish but be sympathetic.

  • Use training pants after the child is using the potty more than half the time.


Discipline

  • When your child misbehaves, immediately isolate him or her in a boring place. This is known as “time out.”

  • Use it when he or she displays aggressive behavior, disruptive tantrums, or dangerous behaviors.

  • Choose a boring location, facing a wall, or a spot on the floor or playpen. Avoid any room that is dark or scary. Never use bathrooms, closets, or basements.

  • Time outs should last one minute per year of age e.g. 4 year olds should be punished for four minutes.



Irvine Family Practice

3-4 years


Eating

  • Make meal time family time. Turn off the TV and have pleasant conversation.

  • Your child should drink about 2 cups of milk a day.

  • Limit juice, soda, chips, crackers and sweets.

  • Provide balanced meals-fruits and vegetables 2-3 times/day.

  • Lots of grains especially foods from wheat, corn, oats.

  • Protein foods twice a day. Examples include lean meat, poultry, fish, eggs or legumes.

  • Give your child water when thirsty.

  • Restrict candy, chips, and other junk food.



Parenting

  • Clean your child’s teeth twice a day. His or her first visit to a dentist should occur at age 3.

  • Limit TV and video game playing to 2 hours a day. Be aware of content and realize that children can be overstimulated and desensitized by programming not designed for children as well as exoised to commercials which can created demand for products your child didn’t ever previously need nor desire.

  • Give your child a helmet and have him or her use it for all bike riding as required by law.

  • Teach your child his or her name, address, telephone number, and how to call 911.

  • Teach your child not to accept anything from strangers or to go with them.

  • Teach your child not to accept bad touching.

  • Don’t yell or spank- be consistent with rules.

  • Play games, talk, sing, and read stories to your child every day.

  • Assign simple chores for your child to do.


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