Don't Panic

Having a new baby is totally terrifying. Don’t get me wrong — it’s exciting for sure. But, first and foremost, it’s stinkin’ scary. Thankfully, there are tons of things about newborns that, while completely fear-inducing, are also completely normal. As a Portland-based pediatrician, and new mom myself, I’ve seen it all. Here’s my top ten list of items every new parents should not worry about (so no need to post that panicked picture on Facebook to crowdsource advice).

1. Erythema Toxicum This is a completely benign rash with a horrible name and a worrisome appearance: scattered little red dots with white centers. It tends to resolve on its own by one week of life.

2. Cross-Eyed Appearance A baby’s eye muscles are often not strong enough to keep their eyes aligned until a few months of age. It can be normal for a baby’s eyes to cross until about 2 months old.

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3. No Poop For Days When a baby is just-out-of-the-womb-brand-new, pooping a lot means they are getting plenty of food. But, after just a few weeks, breastfed newborns can go up to seven days without a stool (as long as it’s mushy when it eventually does come out). A hard stool after that long without another bowel movement does warrant a call to your pediatrician, though.

4. Hiccups Just as the rest of a baby’s nervous system is extremely immature, so is the diaphragm. Some babies hiccup a ton in the first few weeks.
Don’t sweat it.

5. Congestion and Sneezing Babies have been living in a water-filled environment for months when they’re born — it’s normal that they would need to clear out some of that fluid from the nasal passages. If babies have even more fluid after several weeks, though, that’s something to check with a doctor about.

6. Periodic Breathing It’s okay if a newborn’s breathing is not completely uniform. Babies will often have episodes where they breathe fast for a few seconds and then go back to their normal rhythm. If they have continuous fast breathing, it’s worth it to reach out for help.

7. The “Mini Period” Lots of baby girls have a small amount of blood in the diaper at day four to five as their mother’s hormones (estrogen) leave their bodies. We call this a “mini-period.” It may last for a few diapers before resolving, leaving parents everywhere petrified. Large amounts of blood are never normal.

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8. A Stinky Umbilical Cord When the umbilical cord falls off of a baby, it can be kind of stinky. That’s because it is a piece of rotting flesh! It’s okay if there is a slight odor, but if there is extreme redness, swelling or pus, parents should call the pediatrician right away — those are signs of potential infection.

9. Primitive Reflexes Until babies are about 3 months old, they have what we call primitive reflexes (also known as startle movements). The most commonly recognized is the Moro reflex, where a baby puts its arms out to the side and jerkingly flutters them forward when she has the sensation of falling (like when being set on her back).

10. Dry Skin When babies are first born, their skin can look dry and flaky a few days after birth. They were just in a watery environment for months! It takes awhile for the skin to adjust. This is not  dangerous. Just let it be and it will resolve on its own most times.

Whitney Casares, M.D., M.P.H, F.A.A.P., is a mom to two young girls and a pediatrician at Pediatric Associates of the Northwest. She also provides online newborn care courses for new and expectant parents at modernmommydoc.com. She is the author of The Newborn Baby Blueprint: Preparing to Care for Your Infant and Yourself, available at Amazon.com for $15.

Dr. Whitney Casares
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