During the first year of your child’s life, your baby is learning how to experience the world around them – and you are learning how to be a parent. (So cut yourself some slack!) While you will both get the hang of it – and you’ll learn to rely on your instincts – so many questions arise during that first year. And don’t worry: pediatricians have heard it all. No question is too small.
“We are here to help and support you,” says Marisa Elias, M.D., a pediatrician at Henry Ford Health. “When in doubt, always reach out. Even if it ends up being nothing, it’s better to be safe than sorry.”
To preemptively relieve some worries, we asked Dr. Elias to share the most common questions parents have during that first year.
1. How do I know if my newborn is eating enough?
It’s common for newborns to lose weight in the days after their birth, partly because your milk is still coming in. Yet it can be stressful to know whether they are eating enough, especially if you are nursing. How to get that reassurance?
“A lot of it is about trusting our bodies to do what they’re supposed to do – and ensuring you are getting adequate nutrition to produce enough milk,” says Dr. Elias. “But that’s why you have frequent doctor’s appointments in the first few months of life – to see how your baby is gaining weight.”
On a day-to-day basis, there are a few ways you can ensure your baby is getting enough calories: a newborn should have one wet diaper in their first day of life, two wet diapers in their second day of life, three wet diapers on the third day, four wet diapers on the fourth day, five wet diapers on the fifth day – and then six to eight wet diapers a day. They should also get at least eight feedings in a 24-hour period. And don’t let them sleep through the night until they regain their birth weight.
“Wake your newborn every two or three hours to eat,” says Dr. Elias. “When they surpass their birth weight, you can adhere to the adage, ‘never wake a sleeping baby’ at night.”
2. Should my baby be on a schedule?
As your newborn’s circadian rhythm is getting on track, they won’t really be able to maintain any kind of regular schedule until they’re at least three or four months old. Dr. Elias recommends feeding them every two to three hours during the day to help them sleep longer stretches at night. That way, they’ll be less likely to wake in the middle of the night due to hunger.
When your baby is older, you can put them on a regular schedule – but you don’t have to. (Even though it seems like a new parent’s social media feed is flooded with “expert” tips on how to get your baby to sleep through the night and nap in their crib.)
“Schedules depend on what’s best for the family,” says Dr. Elias. “If you need your baby to have a predictable schedule because of your work schedule, we have recommendations for that. But if that’s not necessary for your family, you can go based upon your baby’s cues.”
The only thing that matters is that your baby gets a certain amount of cumulative sleep in a 24-hour period: Newborns often sleep between 16 – 18 hours a day, while infants 4 – 12 months should get 12 – 16 hours of sleep a day.
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3. How much spit up is too much spit up?
All babies spit up – it can be completely normal. “But if your baby looks like they’re in pain while spitting up, if they’re projectile vomiting, if they’re not gaining weight or if they have a lack of wet diapers, call your pediatrician,” says Dr. Elias. It’s also a good idea to burp them and keep them upright for 15 minutes after feeding, which can help limit spit up.
4. When can I take my baby out in public?
“Before a month of age, a baby’s immune system is not very strong,” says Dr. Elias. “If they get a fever, it usually requires a trip to the emergency room. That said, deciding when to expose them to others is a personal decision. If trusted people want to visit your newborn, they aren’t sick and they wash their hands, go with what you’re comfortable with. Just don’t take your baby to a public place where there are tons of people trapped in like sardines.”
5. How do I know when my baby is starting to teethe?
Teething can start as early as 4 months or as late as 13 months. Signs of teething include lots of drooling, gnawing on their hands and appearing fussy. While some say they might get feverish and have diarrhea, Dr. Elias says it won’t be that extreme. They may run a temp of about 99 and their poop might be a bit runnier, but that’s it.
To ease any teething pain, Dr. Elias is a fan of mechanical solutions. “Try a gum massage, cold teethers or put a wet washcloth in the fridge and then let them gnaw on it,” she says. “If they’re experimenting with food, you can also let them chew on a cold carrot or cucumber.
“If these solutions aren’t helping and they’re having disrupted sleep, you can use liquid Tylenol for a night or two – you just don’t want to rely on it too often.”
6. When and how should my baby start trying solid foods?
“It’s nutritionally acceptable to exclusively breastfeed or formula feed for the first six months of life, but some families can start solids as early as four months,” says Dr. Elias. “If your baby has good head control, can sit in a high chair and isn’t tongue thrusting, you could give them purees at four months. Solids between four to six months never replace a bottle or nursing, it’s just for oral exploration.”
Six months is when they can really start solids. “Especially if you’re breastfeeding, you want to introduce iron-rich foods – like oatmeal, leafy greens, nuts, legumes and meat – as their iron stores from when they were born are decreasing,” says Dr. Elias. “But there’s not one ‘right’ food to start with.”
Introduce one food at a time (especially allergenic foods) and serve that food at least three separate times to determine your baby is likely not allergic. Allergenic foods include nuts (you can give them nut butters), eggs, dairy (you can give them yogurt or cheese), fish, soy and sesame. Just don’t give them right before nap or bedtime.
Until about nine months, babies only need one to two meals a day. Beyond nine months, they can eat two to three meals a day and milk intake will naturally decrease.
“I usually recommend a combo of baby-led weaning and purees,” says Dr. Elias. “Baby-led weaning starts at 6 months and is just a different way to offer different textures of food. It allows them to lead the intake rather than the caregiver.”
7. When should I worry about my baby not meeting a milestone?
“We have so many visits in your child’s first year of life because we want to monitor their growth and development to ensure they’re meeting their milestones,” says Dr. Elias.
But you don’t have to immediately worry if your baby is a bit delayed with certain milestones. “If your baby isn’t smiling and cooing at two months, but they are at three months, that’s okay,” she says. “It’s nuanced. Factors like whether they were born premature can influence milestones.”
If you have concerns, tell your pediatrician. “We can give reassurance and intervention if needed,” says Dr. Elias. “There’s also a state program called Early On Michigan that offers free services and intervention during your child’s first three years of life if they aren’t meeting certain milestones.”
8. What vaccines are safe to give my baby?
“We adhere to guidance from the Centers for Disease Control and Prevention about which routine vaccines to give babies in their first year of life and when,” says Dr. Elias. “If you have any questions, ask your pediatrician. We welcome honest and open discussions about our vaccine policies and their importance.”
9. If my baby gets sick, when should I bring them in?
Most of the illnesses your baby will develop in their first year of life are viral. “If they get a fever, you don’t have to bring them in right away,” says Dr. Elias. “But if the fever lasts longer than three to five days and it’s not getting better, and if they’re not making enough wet diapers – or if they aren’t breathing properly or anything else seems off – bring them in. Often, with a viral illness, the first three to five days are the roughest but they should get better from there.”
10. Where can I get help after hours?
And on that note, ask your pediatrician where you can get help in the event of an emergency – or just when you have questions outside of office hours. “At Henry Ford Health, we have a 24/7 nurse hotline (833-262-1949) and we also have a pediatrician on call,” says Dr. Elias. “It’s important where to know to get help, should anything come up on weekends or evenings.”
Reviewed by Marisa Elias, M.D., a pediatrician who sees patients at Henry Ford Medical Center – Royal Oak and Sterling Heights.
