Expert Pediatric Care for Your Newborn
We’re excited to welcome you and your new baby to the Metro family. Newborns gets loads of attention around here and plenty of support! Our providers specialize in caring for our littlest patients and we’re happy to answer all of your questions. You can be confident that your precious babe is receiving the best standard of newborn care.
What to Expect at Your Newborn Doctor Visits
First Visit: If you’re a patient of Metro Pediatrics, one of our pediatricians will see you and your baby within 24 hours of delivery at the following birthing centers: Legacy Good Samaritan, Legacy Mount Hood, Providence Portland, Providence St. Vincent Medical Centers, and Randall Children’s Hospital. Doctors will check the baby’s vital signs, weight, and reflexes, a vitamin K shot, and a hearing test.
Follow-Up Visits: Parents need to schedule follow-up exams for your baby at 1 week, 2 weeks, 1 month, and 2 months. At these visits, your pediatrician will check your baby’s growth and development, and administer needed vaccinations. We’ll also answer any questions you have about caring for your newborn. Learn more about well-visits and vaccine schedules.
More Newborn Care Services
Same-Day Appointments: We’re open 7 days a week and offer same-day appointments for immediate needs. If your baby isn’t feeling well, give us a call.
24/7 Nurse Advice: Call anytime, day or night, and our pediatric nurse advice team help you care for your baby at home, or determine next steps to see a doctor.
Newborn Circumcision: We understand there are important questions and decisions to be made about circumcision. Talk to your pediatrician to get more information and discuss your options for this procedure, which is offered in our clinics within the first 30 days after birth.
Frenotomy: Frenotomy is a quick procedure that can help to improve breastfeeding in babies who have a tight frenulum, which is a tight band of tissue connecting the tongue’s tip to the floor of the mouth. We offer this “tongue-tie” procedure in our pediatrician offices for newborn babies.
Lactation Consultations: Our lactation consultants offer one-on-one support to parents with breastfeeding and nutrition concerns. We can help with latching difficulties, painful nursing, low breast milk production, and more.
Whether this is your first child or you’ve had plenty of experience, we’re happy to answer any of your questions. Here are a few of the top questions we frequently hear from parents.
What medications and tests should my baby have received in the hospital?
- Vitamin K shot. This helps prevent bleeding after birth.
- Erythromycin eye ointment. This prevents damaging infections in your baby’s eyes.
- Hepatitis B vaccine. This is the first of 3 hepatitis B vaccines your baby should receive. It starts the process of creating your baby’s immunity to hepatitis B, a serious liver disease that can lead to cancer. Some mothers are unaware that they have hepatitis B, and it can be passed from mom to baby during labor and delivery. The vaccine decreases the chance that your baby will get hepatitis B, even if exposed during the birthing process.
- Newborn screen (formerly called the PKU test). This blood test checks your baby for additional treatable diseases. It will be repeated at your baby’s 2-week visit to make sure nothing has been missed.
Talk to your provider if you have further questions, if your baby didn’t receive these things, or you’re unsure if your baby received all of these treatments, vaccines, or screenings.
How often should I feed my baby?
Babies need to eat every 2-3 hours in the first few weeks of life. Often, babies will wake up to eat on their own, but you should wake them if it has been more than 4 hours since they last ate. Nursing should take about 10-15 minutes per breast and bottle-fed babies eat between ½-1 ounce at first, increasing to 2-3 ounces by about 2 weeks. They will continue to eat more as they get older.
What should I feed my baby?
- Breastfeeding. Breast milk helps protect your baby against illnesses in the first few months of life, decreases development of chronic diseases like asthma, and is the perfect nutrition for your baby. Take advantage of the lactation services at your birthing hospital for help, even if you have already left the hospital. If you have any concerns with breastfeeding and latching, Metro also provides support through our lactation consultants.
- Formula. If you are going to use formula, follow the mixing instructions on the package exactly or use a premixed formula. Never dilute or concentrate the formula without instructions from your doctor.
- Vitamins. For all babies, whether breast or bottle fed, 400 IU of vitamin D per day is recommended. This is available over the counter.
How do I protect my baby from Sudden Infant Death Syndrome (SIDS or "crib death")?
- Back to sleep. Placing your baby on his or her back to sleep is the most important thing you can do to decrease the risk of SIDS.
- A safe sleep environment. The safest place for babies is in their own space, not in your bed. Their sleeping environment should be a firm surface clear of fluffy toys, blankets, pillows, and other materials that can cover their face. A car seat is not a safe place for a baby to sleep.
- Sleeping with a pacifier. It is best to start the pacifier after breastfeeding is going well, and using pacifiers may reduce your baby’s risk of SIDS.
- A fan in the room. The fan should not point directly at your baby’s face; it should circulate the air.
- Not smoking. Babies whose parents smoke have a higher chance of dying from SIDS. The best way to decrease this risk is to stop smoking. If you cannot stop, you should change your clothes and wash your hands every time you touch your baby after smoking and never smoke in the house or car. Require the same from everyone else around the baby.
- Roomsharing. Have your newborn sleep in your room—room sharing (NOT bedsharing) has been shown to protect babies from SIDS. See the American Academy of Pediatrics’ Recommendations for a Safe Infant Sleeping Environment.
What about taking my baby's temperature?
- You do not need to take your baby’s temperature on a regular basis. You should take your baby’s temperature if he or she feels especially hot or cold, is extremely fussy, is much more sleepy than usual, or is not eating regularly.
- You should call your clinic or take your baby to the doctor if the baby’s temperature is higher than 100.4°F (38°C) or lower than 96.0°F (36°C). Babies under 2 months are at higher risk for serious infections, and fevers can often be the only sign.
- Rectal temperatures are the most accurate. Use a regular digital thermometer with a little Vaseline on the end, and gently insert it in the anus about ½ inch.
A few other important safety tips...
Your baby should always ride in a car seat, even on the bus or in a cab. The car seat should face backwards and be in the middle of the back seat, never the front seat. The straps should be tight enough that you should only be able to get 2 fingers underneath. Blankets go outside the straps, not under.
If anyone wants to touch your baby, ask them to wash their hands first. Babies catch illnesses very easily so everyone needs to be careful to protect them. Babies shouldn’t be around people you know are sick. Avoiding crowds during the first few weeks will help protect your baby from infection.
Okay my baby ate... Shouldn't they poop and pee?
Babies should have a stool in the first 48 hours of life. Over the next few days, their stool turns from blackish brown to green to yellow. Color can vary, but if you see blood, call your doctor. Babies can poop anywhere from 8 times per day to 1 time per week. They may strain, cry, grunt, and kick, but as long as their stool is soft and there is no blood, they are not constipated and do not need treatment.
Babies should have several wet diapers per day, almost every time they feed. In the first few days, babies can have a reddish hue to their urine, called “brick dust urine” because crystals in the urine give it the same color as red bricks.
Reacting to mom's hormones...
Babies are exposed to mom’s hormones while in the womb. These hormones can make changes in your baby’s body until they have cleared, which usually takes a few weeks. Boy and girl babies can get small breast buds, which can even make a little milk. They can also get baby acne, which happens around 2-3 weeks of age. Girl babies can have white vaginal discharge or even a little bloody discharge, usually on the 3rd or 4th day of life. All of these things should resolve on their own.
Mom is also experiencing her own hormones and going through a lot of changes. The “baby blues” are feelings of anxiety, irritation, confusion, fear, tearfulness, and restlessness that are normal and some level are experienced by 50% – 80% of women shortly after delivery. These feelings are generally strongest 5 days after delivery and can last for weeks. Sometimes these feelings progress to more serious depression, so tell your doctor if your baby blues are not resolving or if you are having new or worse symptoms. Look below for more information on Postpartum Depression. Call us if you’re concerned that your “blues” are not getting better.
What is it? Jaundice is a yellow tint to the skin and eyes. It is not present at birth, but may develop after a few days of life and is usually worse around day 4 or 5 of life. It can be due to a combination of dehydration after birth, genetics, mom’s milk production, and feeding ability. The yellow tint comes from a pigment called bilirubin, which is made by the liver.
What are the signs of jaundice? A yellow tint to skin and eyes, increased sleepiness, and poor feeding are all signs of jaundice. When levels are extremely high, babies can suffer seizures and brain damage.
How do we check for it? Your pediatrician will examine your baby for jaundice at the hospital, and your baby will get a blood or skin test before going home. However, the levels are highest during days 4-5 of life, so it is important to see your doctor in the first few days after leaving the hospital. Your baby may need more blood tests to check the level.
How often should my baby cry?
- Babies may cry often; it is the only way they can tell you they need something. If your baby is safe, not hot or cold, not soiled, not hungry, and can be consoled by holding, be reassured. If your baby is unable to be consoled, call your pediatrician. You cannot spoil a baby with attention, however, letting him or her cry while you catch a break is not harmful either!
- Your baby may cry for no reason and you may, as a parent, become frustrated. This happens to everyone.
- NEVER SHAKE a baby. It can cause brain damage that can never be fixed. Don’t be afraid to set your crying baby down in a safe place and walk away if you are frustrated.
- To soothe your baby, try swaddling (learn how from the nurses at the hospital), rocking, walking, bouncing, shushing, singing, or a pacifier.
How often do I bring my baby to the doctor?
The usual pediatrician visit schedule for babies is a newborn check within one week of age, followed by visits at 2 weeks, 1 month, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 2 years, 2½ years, 3 years, then yearly. Learn more about well-child visits.
The purpose of the visits is to answer your questions, check on growth and development, and do a screening physical. Many of the visits include immunizations.