I remember my husband and I walking in the front door of our home with our newborn baby knowing the parenting of this child was our most important undertaking. Those first few months were scary (and amazing). I called the nurse triage line at the pediatrician’s office at least 100 times (no exaggeration). As time went by our confidence grew, but I can honestly say that the most important tool new parents can have is access to a good pediatric practice. We interviewed Dr. Anna Schmelzer at Carolinas HealthCare System’sCharlotte Pediatric Clinic to get the basic questions answered about what to expect from pediatric care.
How soon after I take my baby home do I need to see the pediatrician? How many times? What should I expect at those first visits?
In most cases, infants go to the pediatrician’s office for their first newborn visit 2-3 days after they leave the hospital. If your baby has had a significant weight loss or has jaundice your pediatrician may recommend follow-up the next day. Your child will likely be seen at the minimum weekly until she surpasses her birth weight, which should occur by 2 weeks of age. The initial visits involve weight measurements and questions regarding day-to-day care. After weight gain has been established, the next well check is at one month.
Vaccines
What about immunizations? I’m so confused by all the information (pro & con). How many shots will my baby get over the first year of life. Is the Flu shot recommended?
This is probably one of the most common questions I am asked. It is a complex topic. There are 25 vaccines recommended in the first 15 months of life. This number can sound very overwhelming but when you delve further into the development of a child’s immune system it is better understood. The purpose of vaccines is to give your child’s immune system “memory†to certain diseases. Once vaccinated, that “memory†works to fight off the infection before the symptoms make them very ill or even become life-threatening. The timing of the vaccines is based on when your child’s immune system will respond the best to the vaccines and the earliest age the child can be protected. The current schedule is based on extensive scientific data to support the components and timing of vaccines.
I also get many questions regarding the number of vaccines in a visit and if that overwhelms a baby’s immune system. It is estimated that children are exposed to several thousand germs in a given day and their body has to respond to all of them. In contrast, the antigens given by the vaccines are very small in number. Studies that have looked at vaccines reveal that side effects for vaccines given together are no higher than side effects for vaccines given individually. Mild irritability, pain or swelling at injection site, and low-grade fever are some of the most common vaccine side effects. Signs of serious reactions including hives, a very high fever, rash over a large part of the body, extreme irritability, and difficulty breathing are very rare and warrant a call to the pediatrician or medical evaluation.
There have been multiple scientific studies looking at a relationship between certain vaccines or vaccine ingredients and neurologic changes such as autism or attention deficit disorder. None of these studies have showed that vaccines cause these neurologic changes.
Unlike other vaccines, which are on a set schedule and in most cases protect the child over the course of many years if not a lifetime, the flu vaccine is most effective when given once each flu season. The influenza virus can change each year so last year’s vaccine may not be effective for this year’s flu strain. Influenza can be especially dangerous for children under the age of four and any child with a chronic condition or who is immunocompromised. The American Academy of Pediatrics (AAP) recommends that anyone over six months of age should be vaccinated against the flu. Infants under six months are dependent on the people around them to be flu-free to protect them so it is important for parents, siblings, and caretakers to be vaccinated in order to reduce the risk of infection to them.
This is all very objective on paper and I realize it is different when you are giving permission to administer the vaccine to your own child. I think about it as simply as this: scientific evidence shows us that the benefits of these vaccines far outweigh the risks of them.
Everyone wants to hold my baby
I’m scared all these visitors will get my baby sick. Everyone wants to hold my baby! What do I do?
No one wants to be impolite to well-meaning friends and family. Start with good hand washing for everyone who comes over. In fact, you can greet them at the door and escort them directly to a hand washing “opportunity.†Politely discourage obviously ill people (especially young children who are ill) from holding the baby or even visiting. Your job number one is to protect the baby. That being said, having a newborn is hard work! Enlist healthy visitors to hold the baby while you eat, shower, or sleep.
Safe Sleeping
Safe sleeping? What does that mean?
“Safe sleeping†is a term used to describe sleep positions and the environment recommended to help reduce the risk of Sudden Infant Death Syndrome or SIDS. This includes always placing the baby on his or her back to go to sleep. Avoiding overheating the baby either by overdressing/bundling or having the temperature set too high in his room. Place the baby in a crib that meets safety standards, contains a tight-fitting sheet, and does not have any other items in it such as toys, pillows, bumper pads, or soft bedding. Other safe sleep considerations include a smoke-free environment and pacifier use, which has been shown to reduce the risk of SIDS. Educate all caretakers on these guidelines; they are very different from what was recommended in the past.
What is your best advice for a first time parent?
Parents get caught up in trying to do everything “just right†when the first lesson you learn as a parent is that you rarely have any control (at least initially) over this new situation. It is the most humbling experience you may ever have. New parents get a lot of (sometimes unsolicited, usually well-meaning) advice but I encourage patients to take it all with a grain of salt. What worked for a friend’s child may not be best for your baby. Get to know your baby. Know basic safety guidelines, many of which are common sense. Utilize your support network, which should include your pediatrician. Finally, try to take it day by day.
The saying “the days are long but the years are short†sums it up for me. Take time out of this busy, exciting, frustrating, and joyful time to enjoy your new baby. He or she will grow up quickly!
Dr. Anna Schmelzer graduated from Wake Forest Bowman Gray School of Medicine. She completed her residency at Carolinas Medical Center in 2005 and served as chief residency in 2006. Dr. Schmelzer has been with Charlotte Pediatric Clinic since 2006. She is married with two children ages 3 and 5.
This article was written by one of the many QC women who contribute to our website. They are out and about and around Charlotte digging up the latest & best scoop :)
