What new moms want to know about feeding a newborn

feeding your newbornYou’re home with your sweet bundle of joy and probably have more questions than answers. It won’t be long before you notice a trend – in those first few days and weeks it’s all about what’s going into the baby, and what’s coming out. We want to make sure your baby is healthy and gaining weight.  Here are some general guidelines to help you during those first days and weeks of feeding a newborn.

Breastfeeding your baby

Breastfeeding is a great source of nutrition for your baby, but it’s also a tremendous opportunity to bond with your newborn. We encourage moms to try breastfeeding. While some mothers and babies immediately get into a breastfeeding groove, most take a little more time and need some support to successfully breastfeed. Mott offers a Breastfeeding Support Clinic and lactation consultants to help. If you choose not to breastfeed or if for whatever reason it doesn’t work out, don’t worry, bottle feeding is also a great option.

How do I know if my baby is getting enough to eat?

The best way to monitor that is to track the number of wet diapers each day. For the first week of the baby’s life, he or she should have at least the same number of wet diapers as the number of days old he or she is. So, on day 1, he’d have at least one wet diaper and on day 2 he’d have at least two. By the time your baby is a week old, he or she will be having seven to eight wet diapers a day for the next several months. If your baby does not have enough wet diapers each day, contact your healthcare provider.

How often should I feed my baby?

Until your baby is back to his or her birth weight, you should be feeding him every one and a half to three hours. If you’re bottle feeding, give baby two to three ounces every two to three hours. Do not let your baby go longer than four hours between feedings (and, yes, that may mean you’ll have to wake up a sleeping baby). After your baby has shown consistent growth, you can stretch the time between feedings to include one five-hour stretch. Try to time this so it’s during the night. Encourage your baby to eat more during the day to help him learn that the daytime is for feeding.

Can I over-feed my baby?

It’s hard to over-feed a breastfed baby, but if you are using expressed milk from a bottle, it is possible. Babies typically stop eating when they are full. If baby routinely throws up after every feeding, you may be feeding her too much. Try to incorporate other soothing techniques besides feeding — try swaddling, rocking or a pacifier.

What should a breastfeeding mom be eating?

Breastfeeding moms don’t need to restrict or avoid foods. Just eat a well-balanced diet and stay hydrated. Strive to drink at least 64 ounces of non-caffeinated beverages each day. It’s a good idea to have a glass of water with you when you are nursing. There is no evidence that moms who eat peanuts can cause a peanut allergy in their breastfeeding baby, so there’s no need to restrict your consumption of nuts.

Some babies do have an intolerance to milk and soy proteins. If that happens, your baby will have persistent vomiting after eating and may have blood in his stools. There are hypoallergenic formulas that you can feed your baby if he or she has an intolerance. Your healthcare provider can help guide you through the process of finding a formula that works for your baby.

When should we start feeding baby something other than milk?

For the first six months of your baby’s life, he only needs breast milk or formula. Eating from a spoon, even very runny rice cereal, is challenging even at six months old. Eating from a spoon requires that the baby is neurologically developed enough to suppress the natural instinct to curl her tongue as she does when breast or bottle feeding. Babies do not need water either. Giving water to a baby under six months old is dangerous because it can easily upset the sodium levels in their tiny bodies.

Even with the advice from this article, and the advice you’ll no doubt receive from friends and family, you will probably have plenty of additional questions during your baby’s early weeks. Take advantage of the frequent check-ups your baby has at this age to ask your pediatrician about your questions and concerns. We are here to help!

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Ann Arbor PediatricianLauren Helms, MD, is a pediatrician with C.S. Mott Children’s Hospital. She graduated from the University of Virginia School or Medicine where she also completed her residency in pediatrics. Dr. Helms sees patients at the Briarwood Center for Women, Children and Young Adults.



best children's hospitalsUniversity of Michigan C.S. Mott Children’s Hospital is consistently ranked one of the best hospitals in the country. It was nationally ranked in all ten pediatric specialties in U.S. News Media Group’s “America’s Best Children’s Hospitals,” and among the 10 best children’s hospitals in the nation by Parents Magazine. In December 2011, the hospital opened our new 12-story, state-of-the-art facility offering cutting-edge specialty services for newborns, children and women.


Baby’s here, and so are the “Baby Blues”

what moms should know about the baby bluesHaving a baby is one of the most joyous occasions of one’s life, but that doesn’t mean it doesn’t also come with emotional ups and downs. More than half of all new moms will experience postpartum “blues” about three to four days after delivery. Baby blues are caused by sleep deprivation and hormone fluctuations and typically pass in about one to two weeks.

To help cope with the baby blues, don’t be afraid to reach out for help. Eating well helps, as does getting sleep. Try to sleep when the baby does. Limit well-meaning visitors who may be more of a burden than help for the first several weeks. If you had a c-section, realize that your baby blues may be exacerbated by the stress hormones released while your surgical site heals.

For the first few weeks after baby is born, focus on the fundamentals — eating well and sleeping (for both you and the baby). Spend time bonding with your baby and don’t worry if the house gets dirty or you haven’t showered for a day or two. By the time the baby is six weeks old, life will settle down a bit, and it will settle down even more so by the time he or she is four months old. That’s a relatively short time period to just focus on the fundamentals of caring for yourself and your baby.

Some women have more than the baby blues, they have post-partum depression. Continue reading

Looking for better tests to identify kids with Prediabetes and Type 2 Diabetes

Finding better diabetes testsAs a pediatric endocrinologist, I see many overweight or obese children who are referred for evaluation of prediabetes or type 2 diabetes.

You may be asking, what is type 2 diabetes? It’s the type of diabetes that is associated with carrying excess weight. Only adults used to develop type 2 diabetes, but now unfortunately more and more kids are getting the disease as well.

And what is prediabetes? It’s a condition where individuals don’t have high enough blood glucose levels to be classified as having diabetes, but have a much higher risk of developing type 2 diabetes in the future compared with other kids.

Pediatricians often refer overweight and obese kids to specialists like me for evaluation of these conditions, but they all don’t necessarily need to see us. The problem is that it’s currently hard to distinguish a child with a high BMI who is at risk for developing diabetes from one who is not; if we knew which tests could best identify kids with prediabetes and diabetes, we could save some patients the step of seeing a pediatric endocrinologist, and get the ones who DO need to see a specialist in for an appointment sooner. The challenge is all about getting the right kids to a specialist at the right time, thereby making our healthcare delivery system more efficient and providing better care to those who need it.

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My name is Carl, and I study genes that cause brain tumors in my fight to help Block Out Cancer.

Carl Koschmann, MDEarlier this year, I became a Pediatric Neuro-Oncology Fellow at the University of Michigan C.S. Mott Children’s Hospital.

What does this mean exactly? Aside from this bringing yet another year of training (this will be 27th grade for me!), I will spend a year learning how to take care of children diagnosed with brain tumors, working with incredible pediatric neuro-oncology clinicians, Dr. Patricia Robertson and Marcia Leonard, APRN.

In addition to my clinical work, I will also continue working in the Castro/Lowenstein Lab that focuses on learning more about malignant brain tumors. Drs. Lowenstein and Castro have established tremendous success in developing gene therapies to treat brain tumors, one of which is now the basis of a Phase I trial in adult patients here at the University of Michigan. Continue reading

What we know about the respiratory virus EV-D68 (Enterovirus D68)

Enterovirus d68In late August, Children’s Mercy Hospital in Kansas City, Mo., began seeing an unusual number of children experiencing respiratory problems. The patients tested positive on a respiratory panel administered by the hospital, but that panel could not identify the specific virus. Staff sent the samples to the Center for Disease Control and Prevention (CDC) for further analysis. The CDC determined that the patients were suffering from Enterovirus D68 (EV-D68).

There are about 100 different types of Enterovirus. From June to October every year, some type of Enterovirus usually circulates in the United States. If you’ve ever had a summer cold, it was probably caused by an Enterovirus. EV-D68 specifically is something we don’t typically see in the U.S., but it has been around since the 1960s.

While we’ve seen an increase in patient volume at the C.S. Mott Children’s Hospital emergency department and in our Intensive Care Unit, we cannot conclusively say that these patients have EV-D68. The only way to know is to have lab samples examined by the CDC, which we are working on now.

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Sharing the voices of children with cancer

Trisha Paul, author of "Chronicling Childhood Cancer"Last year, I was invited to be a guest writer on this blog to talk about my experiences volunteering at Mott Children’s Hospital with children on the pediatric oncology unit and how it inspired me to begin an exciting project to share their stories.

Since that time, we’ve been able to turn our dream into a reality.

Our new book, “Chronicling Childhood Cancer,” has been published and shares the voices of ten youth who were undergoing cancer treatment.

Through verbal conversations, written texts, and/or visual representations, these children with cancer shared with me their personal and intimate experiences.

It has been an honor to listen to these children, to give them a chance to have their voice be heard. The written and drawn narratives in the book, some of which are excerpted in the below slideshow, illuminate aspects of childhood cancer that too often remain hidden.

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