Parents' most common newborn mistakes involve car seats, sleep and burping
Pediatricians offer advice on tummy time and fevers
Bringing a new baby home can be nerve-wracking for any parent. If it’s your first, the fear of making a mistake can be overwhelming. It’s inevitable you won’t do everything just right, but read on and you can cross these common mistakes off your list.
1. Car seat safety
Some parents make the mistake of not practicing various baby care chores before the baby comes. While how to change a diaper many be intuitive for most, not everything is. Take car seats, for example.
“Since hospitals require you to take baby home in an appropriate car seat, be sure you have it installed before delivering,” said pediatrician Dr. Jennifer Shu, co-author of “Heading Home with Your Newborn.” “Enlist the help of a child passenger safety technician, if needed.”
Figuring out how to correctly – and safely – install car seats can be a real challenge for many parents, so much so that many fire stations used to help parents with it. Today, fewer do so, but you can find a trained technician through the National Child Passenger Safety Certification site.
But even while parents may have purchased the seat, and even learned how to install it properly, birth educator Polly Gannon finds that some haven’t gone to the trouble of using it before the baby comes.
“Some parents haven’t even put a stuffed animal in there before the baby comes so they know how to get a newborn in there comfortably,” said Gannon, who works at Calabasas Pediatrics in Calabasas, California. “Most hospitals, for legal reasons, cannot put the baby in the car seat for you, or even show you how to use it.”
A 2016 study of nearly 300 families, published in the Journal of Pediatrics, found 91% of those parents made serious mistakes while installing their car seats or putting their newborns into those seats. Eighty-six percent of those errors were in positioning the newborn in the seat, and most of those mistakes were “critical” and increased the child’s risk for injury in any accident. Over half of the families had older children, which should have given them practice for the task.
For newborns, parents should make sure their infant’s head doesn’t flop forward, which could restrict breathing. That involves installing the seat at the correct angle to keep the baby’s feet up, with the body reclined so baby can turn her head to the side and breathe normally.
If the baby slouches down or to the side in the seat, the American Academy of Pediatrics suggests placing a tightly rolled receiving blanket on both sides of the baby, or using the newborn insert made for that car seat brand – do not mix or match with other manufacturers. Don’t place a blanket or roll across the top of the baby’s head or put padding under your infant.
2. Back to sleep
The national “Back to Sleep” campaign of the 1990s brought a great deal of attention to SIDS, or sudden infant death syndrome, and other sleep-related deaths among infants. Guidelines from the American Academy of Pediatrics insist that every baby should sleep on their back, in their own crib, without any toys or soft bedding. During and after the campaign, sleep-related deaths sharply declined, but recent data shows the risk continues. Each year, some 3,500 babies continue to die from sleep-related causes.
A 2015 study by the Centers for Disease Control and Prevention found one in five mothers report putting their baby to sleep on their side or stomach, and 39% of mothers said they use soft bedding in the crib with the baby.
“Wow, that’s alarming because you’d think everyone would know the recommended way to put their baby to sleep,” said pediatrician Dr. Tanya Altmann, author of the new book “Baby and Toddler Basics.” “But what a lot of parents still don’t know is that you should not use bumpers anymore, and you don’t want pillows, toys or extra stuff in the crib.”
3. Not feeding on demand
Some new parents make the mistake of letting baby sleep too long between feedings, likely due to exhaustion and their own need to get a bit of rest. But that’s a mistake, say experts.
“The first few weeks, the baby does need to be fed … every two to three hours, even if they don’t demand it,” said Altmann. “But once they have regained their birth weight and you get your pediatrician’s OK, it’s fine to cross your fingers and hope that you get a stretch of three to five hours without the baby waking to be fed. But in the first few weeks, babies do need to be woken up.”
If you’re doing everything right and your baby is growing and developing well, said Altmann, it’s perfectly possible to get a baby to sleep through the night by 2 or 3 months of age. But be aware that some babies regress between three and four months and begin to wake up more frequently and feed more often.
“If you jump in and turn on all the lights, start playing with them, and basically have a party in the middle of the night, they will continue to wake up,” Altmann said.
“I usually tell parents if every time you wake up there was chocolate cake on your nightstand, you would start eating it every night and you would wake up expecting it,” she said. “Same with babies, right?”
4. Not burping baby properly
One of the key mistakes many new parents can make is failing to take the time to properly burp their newborn.
“I think many new parents are nervous about handling their newborn,” said Gannon. “They will often put the baby down quickly after feeding because they are scared they aren’t holding it properly.”
The result of failing to burp is that the baby may spit up and gag, losing some of that precious milk, or wake up in an hour or so screaming in pain.
“I’m getting calls all the time where parents say that the baby is really peaceful after feeding, but then baby wakes up screaming and is up for the next 2 1/2 hours,” added Gannon. “My favorite line is ‘cheat the baby, cheat yourself.’ If you cheat the baby out of a good burp and fail to get all of that air out, you and the baby are both going to suffer.”
There are several burping techniques you can try until you find the one that works best for your baby. In the most well-known, the-over-the-shoulder burp, you place your baby high on your chest with her chin resting on your shoulder and face turned to one side, tummy firmly against the chest. Pat or rub the baby’s back gently until she burps.
“It might take you an additional 10 minutes at the end of the feed,” said Gannon, “but the baby will be happy.”
Another common technique is to place baby face down across your lap, and pat and rub. Other techniques include baby exercises. Lay them on a blanket on the floor and begin bicycling their legs, or moving their legs up and around in a circular motion in each direction.
Gannon finds that a sitting posture works best for her clients. She places the baby sitting upright on her lap, facing the side. Using one hand to support the baby’s head in the front (making sure to avoid holding the neck) she puts her other hand on the baby’s back.
“Keeping the baby’s bottom firmly planted on my lap I move their whole body in a small, slow circular motion to the left for a while, then to the right for a bit,” explained Gannon. “I sit the baby upright a few times, and usually get a good, hearty burp, even without a gentle pat on the back.”
5. Failing to pre-burp
Most of us think about burping after the baby eats. But experts say that you should also take the time to pre-burp your baby.
“I try to pre-burp baby for at least two minutes before starting any feeding,” Gannon recommended. “This helps eliminate the common spitting up and gassy problem that newborns often have for the first 30 days.”
“If you start out without gas in the stomach, and then do a really good feed and get the gas out at the end, they are going to be much more comfortable and more likely to be happy and content on their own,” added Altmann.
6. Mistakes in mixing formula or breastfeeding
Making a mistake measuring formula and water happens often enough in her practice, said Altmann, that she makes it a practice to quiz parents on how they prepare baby’s meals. She asks the same of breastfeeding moms, too.
“When I have new babies come into my practice,” said Altmann, “whether they are breastfeeding or formula feeding, I take a step back and ask these questions: ‘Exactly how are you feeding your baby – what do they look like when they are latched on? How are you mixing the formula? How are you putting it in the bottle?’”
On occasion she finds that one of the parents might be mixing formula wrong, by making it too concentrated or dilute.
“Usually, it’s too dilute,” said Altmann. “Then the baby isn’t getting enough nutrition and that’s when they fail to thrive. You always want to be sure you’re reading and following the directions on the formula properly.”
And some moms may not have the baby fully latched onto the breast, so while the baby looks like it’s nursing, he or she isn’t actually swallowing and feeding, said Altmann.
“It’s a good idea for breastfeeding moms to check in with a lactation consultant if they have any concerns or pain during feedings,” said Altmann. “Then check in with your pediatrician regularly to make sure your baby is gaining weight appropriately.”
7. Not enough tummy time
Altmann says an unfortunate mistake many new parents make – and continue to make as baby grows – is keeping baby constrained in a car seat, bouncy seat or other sleepers.
“I’ll see parents out with their baby, at a restaurant, at the park, talking to friends, and they are carrying the baby in the car seat,” said Altmann, who is also a spokeswoman for the American Academy of Pediatrics. “I’m always telling parents, ‘Car seats are for cars, but don’t carry them to and fro in the car seat.’”
Not only can spending too much time reclining create a soft spot on the back of their head, says Altmann, but not interacting with the baby can cause language delays and other issues due to a lack of stimulation.
“When your baby is not sleeping or not in the car traveling, they really should be on their tummy or held by a parent,” Altmann said. “They shouldn’t be strapped down, they need to move, stretch, roll and push their head up.”
8. Under- or overreacting to a fever
Fevers in newborns can be serious. If your baby is younger than three months and develops a fever of 100.4 or higher, call your pediatrician or medical professional immediately. But when it comes to a fever in babies and children older than that, the advice is more complex.
“For the older babies, I’m usually telling parents not to freak out by what the number says on the thermometer,” explained Altmann. “Instead, take a close look at your child to figure out what is happening with them, because not every fever needs to be treated.”
Look at your baby and observe. Are they drinking fluids? Are they happy and playing? Are they sleeping OK? Are they having any trouble breathing? Those are the questions to ask yourself, Altmann said. Experts say most fevers are harmless, and likely the result of a mild infection.
“Don’t just treat the number on the thermometer,” Altmann added. “It doesn’t matter if it’s 101 or 103.5, it’s more important how they are acting.”
9. Proper temperature for baby in the home
Another concern for parents: how warm or cool their baby should be. Shu said she is often asked by parents for the proper temperature setting for the home. The answer, she says, depends on the time of year and the insulation of the home, but in general “a thermostat setting around 68 to 72 is probably comfortable for baby.”
While Shu says she thinks many parents keep baby too warm, Gannon has found the opposite. At homes in her practice, she said, new parents may have their baby in a T-shirt and diaper, unswaddled. She said a baby’s skin should always be warm, not hot or cold, to the touch.
“If the baby is chilled, then his body will need to burn extra calories to raise his body temperature, instead of those calories going toward a healthy weight gain,” said Gannon. “So even if the baby is feeding well, he or she may not be developing properly because they have to burn a lot of calories trying to get warm.”
Shu warns that newborns don’t have good circulation at first, so “having cool hands and feet is normal.”
10. Taking newborns into crowded places
Some parents want to take their newborn to a large family gathering so everyone can ooh-and-awww over their tiny miracle. That could be a mistake, experts said.
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“It does scare me a bit when I see newborns out and about, especially during cold and flu season,” said Altmann. “The first two months of your baby’s life, you really need to protect them from exposure to germs and people that are potentially sick. Your baby’s immune system is weak, and still growing and developing.”
That doesn’t mean you can’t leave the house, however. Experts encourage daily walks and say it’s fine to sit in your backyard or on the front porch.
“But don’t take them to crowded spaces,” Altmann said. “That’s when you can expose them to people who potentially have the flu or another contagious illness that could spread, even if they are a few feet away.”