Dear Parents:

Congratulations on the upcoming birth of your child!

Complimentary information included for you to review include the following:

  1. choosing a name for your child
  2. choosing a pediatrician
  3. essential needs for your home
  4. choosing child care
  5. at the hospital
  6. breast feeding versus formula feeding
  7. whether or not to circumcise your child
  8. normal newborn behavior
  9. when to call your pediatrician

When your pediatrician visits you after your child’s birth, he or she will give you specific advice regarding infant care. Be sure to have all of your questions and concerns addressed before you leave the hospital. In general, a good idea is to write your questions down as they come to mind.

The birth of your child is a joyous occasion. We hope that this information will help you with the planning so that you can enjoy this special time.

Best wishes for a happy and joyous parenthood!

The Providers at Primary Pediatrics, PSC.

Dr. Sheila Harmeling; Dr. Amanda Dropic; Dr. Mike Fiedler;  Kristie Thelen, APRN; Mandy Race, APRN

59 Cavalier Blvd. Suite 330
Florence, KY 41042

Phone: 859-371-3232 Fax: 859-371-6943


This is one of the most enjoyable preparations we have as expectant parents, though it can be an anxiety provoking experience as you get down to the last few names. It is often helpful to repeat the possible names out loud intermittently. Additionally, writing the names out on paper may help. Many parents often choose their child’s name based on the meaning of the name, and there are many good websites to help you figure out the meaning of names. While the input of friends and family may be helpful, the ultimate choice is yours. Don’t put yourself in a position where you choose a name that you really didn’t want. Whatever name you choose, your child will love it.

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When considering a Pediatrician, the following issues are worth considering:

  1. Small versus large practice: Small practices often allow you the opportunity to develop a relationship with your Pediatrician, and visa versa. Many pediatricians are interested in your child’s life activities in addition to their general health. A good relationship between your pediatrician and your family enhances the overall physical, emotional, and intellectual development of your child. Identifying a certain provider that you are comfortable with often allows for ease in addressing sensitive issues. One advantage of larger practices is multiple locations with easier access. Is this a concern for you?
  2. Availability: Are the providers in the office on a part time or full time basis? Will you be able to speak with your primary provider within a day if necessary?
  3. Office hours: What are the office hours of your Pediatrician? It is important that your Pediatrician offer office hours on all weekdays. If they do not, ask what alternate coverage is available. Additionally, are Saturday hours available? Is there a restriction on which days check-ups are available?
  4. Sick visits: Does the practice stay open to see all sick patients on the day that you call, or do they close at certain time?
  5. Initial consultation: Many pediatricians offer a complimentary, initial consultation for expectant parents. These usually last from 15-30 minutes. Call for an appointment.
  6. Personal care versus phone trees: Does the Pediatrician’s office rely on a phone tree, or will you be able to talk to an individual to relate your concerns. If a phone tree is in place, how long will it take to get a call back from an individual?
  7. Location: Where is the office located? Is this convenient for you with respect to work, home, or day care?
  8. Hospital privileges: Which hospitals do the doctors admit to? Do they see their own patients, or do they rely on the hospital physicians to care for your child?
  9. After hours service: Do the providers take call themselves, or do they hire out an agency? How long does it take to receive a return call? How do they handle emergencies?
  10. First visit: When will your pediatrician see the child for the first time? Will it be at the hospital?

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As you get closer to your “due date” you will want to have your home ready for your child. By your 36th week of gestation, the following items should be available in your home:

  1. Rear-facing infant car seat (in the car when you go to the hospital) – the majority of car seats are installed incorrectly, your local fire dept will check installation for free by appt
  2. Crib or bassinet
  3. Bathtub (plastic infant tub)
  4. Diapers and wipes
  5. Bottle and nipples
  6. Pacifier
  7. Plastic suction bulb ( the hospital usually provides)
  8. Diaper bag
  9. Rectal thermometer
  10. Formula (even if you breast feed in case of personal illness)
  11. Clothes/Blankets
  12. Infant Tylenol

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Unless you have previous experience with an individual or agency, it is difficult to avoid anxiety when making this decision. It is often helpful to observe daycare personnel in their work setting, while with children. It is a good idea to make a scheduled visit and an unscheduled visit – most providers will welcome your visit at any time. Checking references is a must. Another point worth considering is the child to care-giver ratio. Finally, what is their policy with handling sick children?

Some qualities to look for in a caregiver include affectionate and supportive approaches to children, patience, and the ability to be a good listener. Your general feeling about the individual will also be very important.

Your pediatrician may know of some good day care facilities. Don’t be afraid to ask their advice.

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Nearly every hospital offers pre-registration for expectant mothers. If you have chosen a pediatrician, that can be included in the pre-registration. Also, the hospital may give the first hepatitis vaccine immediately after birth. If your pediatrician prefers that you do not give the vaccine at birth, this can be included in your pre-registration information.

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As you get closer to your delivery date, it will be very helpful to have the following list of items ready:

  1. The car has a full tank of gas,
  2. You have your obstetrician’s phone number readily available.
  3. The baby’s car seat is in the car.
  4. Your suitcase is packed with a change of clothes.
  5. If dad is staying with you, his suitcase is packed.
  6. An outfit for the baby is packed.
  7. Camera with film and fresh batteries is packed.
  8. Babysitting is arranged for other children or your pets.
  9. You have a list of names with phone numbers of important people to call after your child is born.
  10. A portable radio or CD player with music you will enjoy.
  11. Books/magazines/cards

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At the actual time of your child’s birth, there will be a lot of excitement. Your obstetrician will be totally focused on your well being and the baby’s well being. Some conversations between the doctors and nurses may not be easily understood. Be reassured that your obstetrician and nurse will fill you in on all of the important details as soon as possible.

After the birth of your child, you will likely be able to hold him or her. For a short while after the birth (approximately 5 minutes) your child will be taken over to a warmer. At that time, your child will be cleaned up and dried off, assessed by the nurse, receive a shot of vitamin K, and have an antibiotic ointment administered to the eyes. If you elect to receive the first hepatitis B vaccine, it will be given at that time. The child will then be brought back to you. If you elect to breastfeed, the baby may be placed skin to skin at that time.

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The two decisions parents are faced with immediately after birth are how to feed the infant, and whether their son should be circumcised.

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Breast feeding (Nursing)

Nursing is a wonderful, healthy, and natural means of feeding your child. All evidence clearly indicates that breast feeding results in an overall decrease in the number of infectious illnesses infants experience in the first six months of life. Additionally, it offers an opportunity for special bonding between you and your child. If you elect to nurse your child, during the first few days, your breast will produce thick yellow milk called colostrum. After 2-5 days, your milk will “come in”. At that time your breast will feel engorged, and you will feel a “let down” with each feeding. Additionally, you may feel some uterine cramps when you nurse your child. This is a normal hormonal response that is transient in nature.

The amount of milk your body produces is directly related to how often the infant nurses. The size of your breasts has no correlation with milk production. However, previous breast surgery may affect how well your infant nurses. If there are any concerns with nursing, your pediatrician will address these concerns with you, and may request assistance from the Lactation Consultant. Your pediatrician will also discuss whether or not any vitamin supplements should be included in the infant’s diet.

In order to maintain equal milk production between your breasts, it helps to alternate which breast you initiate the feeding on. Also, your infant should open his or her mouth wide enough to latch on to as much of the areola (darker portion of the breast around the nipple) as possible. In doing so, the infant will squeeze the areola, not just the nipple. Occasionally, your may be so engorged that your child cannot “latch on”. In those situations, pumping for a few minutes to “soften” the breast usually allows for a better latch. Your pediatrician or lactation consultant can help you with this. It also may be helpful to locate a breastfeeding class prior to your baby’s birth (most are offered by the hospital at which you will deliver).

Formula feeding

The decision to nurse or bottle feed your child is a personal one. As a mother, there are many things that you will do for your child over the years that will make you a great parent. The decision to formula feed does not define you as a good or bad parent.

There are many different formulas available. Your pediatrician will help you choose one. Additionally, formula can be supplied as powder, concentrate, or ready-to-feed.

It is not necessary to boil the bottles or the nipples. Additionally, city water from the tap is safe to use without boiling. City water contains the minerals needed for normal growth and development.

Formula should be given anywhere from room temperature to body temperature (97 degrees). Warm water from the tap is usually sufficient. Alternately, keeping the bottle in luke warm water in the sink for five minutes will help achieve a good temperature. Do not place milk in the microwave to warm, as it can form hot spots and scald the baby.

Most infants feed every 2-3 hours in the first week. The amount ingested can vary from 1-3 ounces each feeding. Do not give your child water. Remember not to change the formula without consulting your child’s pediatrician.

Is my child getting enough breast milk or formula?

A general guideline to follow is that an infant should urinate at least once in the first day of life, at least twice in the second day of life, an at least five times a day from day 3 onward. Infants may have a bowel movement with each feeding which is normal. Most infants should have at least one bowel movement a day. Also, try to assess whether your child acts satisfied. Most babies will lose up to 10% of their birthweight before they start to gain weight. Your pediatrician will let you know if they have any concerns.

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Whether to circumcise is a personal parental decision, not a medical one. There is some evidence to suggest that circumcision may protect against urinary tract infections in the first year of life. While circumcision does not protect against sexually transmitted diseases, it does decrease the risk of contracting some of them. Circumcision also protects against cancer of the penis, though to no greater extent than good hygiene. Again this is a personal decision.

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Prior to discharge form the hospital, your child will have routine screening tests performed for some genetic disorders. Your pediatrician will receive the results in 2-3 weeks. Additionally, your child will receive a hearing screen in the hospital. It is not uncommon for an infant to fail the initial hearing screen and still have normal hearing. This is usually do transient fluid retention in the ear canal.

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Newborn infants display unique behaviors that can alarm the unsuspecting parent. You will notice that your child may sneeze and have hiccups frequently in the first two months of life. Additionally, your infant may have intermittent jitteriness of his or her lower lip. It is normal for your infant to startle very easily, with spreading of the arms and legs. These are all normal behaviors. Little girls may have mucous like or even bloody vaginal discharge in the first week. Again, this is normal. Both boys and girls may have some breast tissue; this is due to the exposure to your hormones, and will resolve in 1-2 months.

Your infant’s skin will likely peel for several weeks after birth. In addition, chafing of the buttocks and cheeks is common. If you notice pimples, blisters, or the skin becomes very raw, call your pediatrician.

The umbilical cord should be kept warm and dry. When it falls off, you may see a drop of blood, which is normal.

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Your pediatrician will review his or her specific guidelines with you, but as a general rule, you should call your pediatrician if you experience any of the following:

  1. Rectal temperature of 100.5 degrees or higher or 97 degrees or less.
  2. Vomiting for more than two feeds or greater that 4 hours
  3. Blood in the stool
  4. Excessive fussiness not relieved by feeding or cuddling / swaddling.
  5. Yellow skin (jaundice) that involves more than the face, or involves the white part of the eyes.
  6. Refusal to eat for more than 6 hours.
  7. Difficultly breathing as evidenced by flaring at the nose, grunting with each breath, bobbing of the head with each breath, or blue lips.
  8. Circumcision is bleeding, appears infected, or is not healing.
  9. Less than five wet diapers a day after the second day of life. It is common to see only one wet diaper in the first day of life, and two in the second day of life.
The umbilical cord has persistent drainage, or the skin around it is red and warm to touch.

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