Medications and vaccines

Immediately after giving birth, routine care for newborns includes a few different treatments. It can be really helpful to know more about these recommendations ahead of time!

An antibiotic eye ointment, called erythromycin, is a clear gel that is gently squeezed into each eyelid. It looks greasy, but should not cause your baby any discomfort. It helps to protect against an eye infection called neonatal conjunctivitis that can be caused by many different bacteria present in the vagina, or rarely in amniotic fluid. Neonatal conjunctivitis can cause serious complications like blindness and requires IV antibiotics for treatment. In some states, you may not be able to sign refusal for this medication, it is mandated by law. 

Vitamin K is a small injection of — you guessed it — Vitamin K. Vitamin K is essential for forming blood clots. After infancy, our bodies develop bacteria in the gut that make Vitamin K for us. But when they’re born babies don’t have this in their bodies yet. The shot gives them protection against bleeding while they develop their own gut bacteria to take over the job of making the vitamin for them. 

Not having enough vitamin K can cause bleeding issues that range from minor — like a little extra bleeding after getting a shot — to a severe condition called Vitamin K Deficiency Bleeding, which can be fatal. Many parents are curious about using oral Vitamin K as an alternative to the shot. This is an option, but because Vitamin K in this form is processed through the digestive system (instead of going directly into the muscle and being absorbed into the bloodstream with the shot), oral doses have to be given weekly and are less effective than a one-time injection of the vitamin. Therefore, they are not typically offered or recommended. 

Hepatitis B is the only vaccine recommended for newborns. It is part of a 3 dose series, which is continued at your well-baby visits. If you have tested positive for Hepatitis B during pregnancy, the routine for your baby’s care will be slightly different.

Hearing, hearts, and jaundice

Some routine testing, like a hearing screen, cardiac screening, or bilirubin scan, are brief and non-invasive. Checking your baby’s hearing, pulse oximetry, and their jaundice level are all things you can expect before going home. If there are any red flags on those tests, your pediatric provider will discuss your options and next steps (which are often just re-checking the tests at a later hour or day). 

You might wonder why it’s so important to do these tests in the first days of your baby’s life. Let’s break it down. 

Hearing test 

A hearing test is important because even a newborn baby is already learning language. If their hearing is impaired (even in just one ear) knowing and addressing it early on can make a big difference for your baby’s language development. 

Oxygen levels

A pulse oximetry test of your baby’s oxygen level in different parts of the body — usually done by putting a sticker with a red light on your baby’s hand and foot. This test can help to catch worrying heart problems that happen in about 1 in 1,000 babies and might otherwise go unnoticed. 

Jaundice screening 

Jaundice screenings, often also done with a special light placed on your baby’s skin, make sure that bilirubin levels aren’t getting too high. Sometimes instead of a skin sensor, this is checked using a blood test, collected along with the blood sample discussed below. High bilirubin levels can cause problems like lethargy, poor feeding, and in some rare extreme cases, brain damage.

Newborn screening

Newborn screening is another test that is typically done after your baby is 24 hours old. It involves a small blood sample. You might picture having your blood drawn in your arm as an adult, but this test requires a very small sample and it can be tricky to find a tiny newborn vein. So most of the time, a heelstick is used. Your baby will have their foot warmed and then a small prick is made in their heel. Some babies barely notice, others might cry. Blood is collected onto a paper form, which is sent to your state’s processing lab by the hospital. 

But why?

The biggest question is, what are they screening my baby for? And that’s a great question! The answer varies because testing is a little bit different in each state. In general, the test covers multiple conditions that a baby can be born with and are impossible to see on a physical exam. Most of these conditions have treatments that are important to start early in life, so testing is essential.

It can be helpful to check what the testing requirements and suggestions are in your area, and discuss any particular concerns you have with your pediatric provider — such as a family history of a metabolic disorder. You can look up what your state tests for here if that information isn’t provided by your hospital. If you give birth outside of a hospital, it’s recommended that you have newborn screening done between 24 and 48 hours of life. This can typically be done by your home birth or birth center provider, or at a lab. 

Reviewed by the Ovia Health Clinical Team

Read more

• Recommended immunization schedule for baby’s first year
• Baby check-ups

Dear Ovia, How do I get my husband involved more with the baby if he’s not a “baby person”?

I hear you on this! I definitely had a partner who was terrified of the newborn stage. Too small! Too delicate! That soft spot! Ah! Not all stages are our favorites, and some general acceptance of that being normal may be helpful. If he’s excited about older ages and stages and doesn’t prefer where you are now, try not to judge the excitement factor. 

That said — it doesn’t excuse him from equal parenting, division of labor and (as you said) involvement. He can be less into a certain stage (it’s possible that you may not love a future stage when he’s all in), but he still has to be your partner and be loving and helpful. If dropping hints like, “The baby loves when you sing!” or “Can you read to the baby?” hasn’t worked, it’s time to up the ante. 

Consider asking that he be fully responsible for certain things. This means he’s the breakfast guru or the bathtime expert while you disappear. Having a sense of independence, bonding and responsibility will hopefully show him the joy of this stage, but at the very least it will allow him to relieve some of the pressure on you. Plus, sometimes it helps when a parent discovers their own way of doing things.

He should also have tasks like diaper ordering, meal planning, or washing pump parts — not just bonding activities. The mental load of caring for a baby is immense, and sharing these logistical tasks also counts as involvement.

Lastly, when you do things together as a family, try asking him to step into the role of wearing the baby, pushing the stroller or swing, etc. Often you may feel natural in those roles, but asking him to fill those shoes involves him and changes the overall dynamic. 

Read more from this series

• I’m just not in the mood
• Responsible for all the infant care

Parents may feel sad, disappointed, or angry for not getting the experience they had envisioned, like their body has failed them somehow, or even that they failed their baby in some way. Whether these feelings stem from a traumatic birth or the loss of a hoped-for moment, they are valid. If you’re struggling to accept your birth experience, here are some ways to navigate complex emotions and honor your own strength.

Be open to your negative feelings

You might put pressure on yourself, or receive well-meaning advice, to focus on the outcome of your experience instead of dwelling on the difficult details. But the truth is, giving your genuine emotions space to surface can actually help you process them. This doesn’t mean you need to speak freely with everyone about your birth and listen to their input and advice. It’s okay to set boundaries for yourself and have a few good responses for when you’re not ready to talk about it. Simply saying something like, “This is still a very sensitive space for me and I’d like to talk about something else,” is perfectly acceptable. Your birth story matters, it is yours to share on your own terms. And holding parts of it close and/or grieving any part of it does not take away from the love and gratitude you feel for your new baby. 

Processing your story when birth doesn’t go as planned

When birth doesn’t go as planned, it can be helpful to talk with your doctor or midwife afterwards (when you’re ready). They can help answer any lingering questions you might have and provide clarity on why things unfolded as they did. Having insight into why your provider made certain decisions might help you view your experience in a new light or just better understand what happened that day or night. It can also be therapeutic to write out your birth story and/or the story you had envisioned for your birth. The writing process can help you identify and validate the emotions you are experiencing. You don’t need to have writing expertise or even show your story to anyone for it to help. Finally, talk about your feelings with a loved one or counselor if that’s possible for you. Ask loved ones just to listen so you can fully express how you feel.

Give yourself credit

It took considerable strength and a whole lot of love to carry and give birth to your baby. Your body accomplished an incredible feat, and you adapted as best as you could when your story didn’t go as planned. Acknowledge the courage it took to face the uncertain moments and keep moving forward. You did what was necessary for you and your baby and you have so much to be proud of. You are not less of a mother or parent because you grieve any part of your birth experience. It might be hard to feel this way right now and that’s okay. It’s okay to feel robbed of what you had anticipated and grateful for your baby. It isn’t straightforward and tidy. Emotions can be really messy.

Ask for help when you need it

The postpartum period can be full of complex and overwhelming emotions in addition to the physical healing you’re doing. Lean on the close relationships in your life and let people you love know when you’re having a tough time. It can also help to seek out a group for new moms in your area. Finding friends who relate to your experiences can be comforting. If your emotions feel too heavy to handle, even with your support system, or impact your ability to get through the day, talk to your doctor so you can be assessed for postpartum depression or post-traumatic stress disorder (PTSD). You don’t need to face this alone, and there are treatments (including counseling) that can help. You can feel better.

The bottom line

When birth doesn’t go as planned, it’s essential that you allow yourself space to grieve. It’s understandable to have expectations for such a big life moment and to experience disappointment when things happen differently than you hoped. Take it day by day, treat yourself kindly, and know that as difficult feelings surface, they can also begin to heal.

Reviewed by the Ovia Health Clinical team 

Sources

• “Births – Method of Delivery.” National Center for Health Statistics. Centers for Disease Control and Prevention. March 2, 2021. https://www.cdc.gov/nchs/fastats/delivery.html
• “C-section.” Mayo Clinic. Mayo Clinic. June 12, 2020. https://www.mayoclinic.org/tests-procedures/c-section/about/pac-20393655
• “Pain Management for C-Sections.” Yale Medicine. Yale Medicine. https://www.yalemedicine.org/conditions/anesthesia-for-c-section
• “Cesarean Birth FAQs.” Acog.org. The American College of Obstetricians and Gynecologists. 2021. https://www.acog.org/womens-health/faqs/cesarean-birth

We’ve all experienced that special burn that you only get when shampoo runs into your eyes during a shower. One minute you’re singing off-key and massaging the shampoo into your scalp, and the next, your eyes are burning with the heat of a thousand hot sauce flavors. It’s shocking and unpleasant in the absolute worst way. And it might make you nervous about switching Baby from no-tears baby shampoo to a different kind. 

For now, Baby is probably enjoying the no-tears baby shampoo. But as Baby becomes less of a baby, when is the best time to leave it behind? There is really no right answer, but there are a few factors you will probably want to consider.

Can Baby tilt their head back, and close their eyes on command? 

These are pretty important skills for Baby to know in the fight against soapy eyes! If Baby can’t yet do either of these things, it will be in your and their best interest to stick with no-tears shampoo for the time being.

How thick or long is Baby’s hair?

Some toddlers at this age are already sporting a full head of hair. Others barely have a combover. Baby shampoo isn’t exactly designed to nourish luscious locks, so if Baby has long, curly, or thick hair, it might make sense to want to switch to adult shampoo earlier in their toddlerhood.

Also, how dry is Baby’s hair? Baby shampoo does irritate some children’s scalp and hair, so if you see dryness or irritation, you probably want to stop using baby shampoo. Basically, the point when you start to notice the baby shampoo not doing quite a good enough job keeping Baby’s hair clean may be a good point to start thinking about making the switch.

What’s Baby’s preference?

Some toddlers love the smell of baby shampoo, whereas others might scream when they’re called a baby. If Baby leans a certain way in regards to their hair-washing preferences, that’s something to consider too.

There’s really no right or wrong timeline with baby shampoo. Some adults still use it when they’re out of their own adult shampoo! Don’t feel pressured to make the switch right away, because at the end of the day it’s up to you and Baby.

Sources

• Catherine D. Coret, Michael J. Suero, Neena K. Tierney. “Tolerance of natural baby skin-care products on healthy, full-term infants and toddlers.” Clin Cosmet Investig Dermatol. 2014; 7: 51–58. February 5 2015.

Exercise impact on milk while breastfeeding

If you’re breastfeeding, even intense exercise should not impact how much milk you produce or how willing Baby is to feed. As long as you’re staying comfortable,hydrated, and fueled with enough food, exercise is beneficial for most new parents. Even a simple walk with Baby can increase cardiovascular fitness levels, improve insulin response, and decrease anxiety, 

Debunking the myths

For a long time, the impact of exercise on breast milk was covered in mystery. Then a widely publicized study from over 20 years ago found that breast milk is higher in lactic acid right after exercise, and that babies find it less appealing for that reason. The study concluded that mothers should pump or nurse prior to exercising and avoid nursing until an hour after exercise. Later research called this finding into question due to the use of a medicine dropper to feed these babies (not the breast or bottle). Because  the babies were unaccustomed to feeding from a medicine dropper, this likely impacted the study’s accuracy.

Other studies showed increased milk supply for women who exercised regularly, and decreased IgA levels – antibodies that fight infections – in women who had exercised strenuously. IgA levels returned to normal after 30 minutes, however, which makes the finding less significant in the bigger picture of breastfeeding. Overall the findings of these studies do not merit any change in exercise patterns.

Preparing for exercise

Make sure to support your breasts as much as possible – wearing a supportive sports bra is a must, and if you need to add extra support (doubling up on bras, for example), don’t hesitate to try. Some folks find it best to pump or nurse prior to exercise to minimize pain during high impact exercise such as running. Hydration is particularly important during breastfeeding, as is pairingexercise with enough food and water to offset what you lose during any exercise sessions. It is possible for milk supply to decrease if you exercise and don’t fuel your body appropriately. 

Don’t get discouraged if exercise is difficult at first, even if you exercised during pregnancy – between recovery from childbirth and all of the energy that goes towards taking care of Baby, it only makes sense that exercise might be harder than you were expecting. During your workout, take care with any exercises that might cause injuries, especially soon after giving birth. The hormone relaxin may still be in your system, which could make your joints more flexible, which can make it easier to push your body too far. If lack of sleep is making it hard to get motivated, try starting slow with a simple, short walk most days.

Post-workout, as long as Baby is happy to nurse, there’s no reason not to nurse right away. Some babies don’t like the taste of sweat, so if you’re concerned, you can shower off or wipe down before nursing to prevent this.

The bottom line

Exercise isn’t just safe when breastfeeding – it’s downright healthy! Whether yoga, lightweight exercise, or something more strenuous, exercise will help keep you healthy for the months and years to come. Remember to take it slow after you get clearance to start more activity at around 6-8 weeks postpartum. Listen to your body’s cues and be sure to fuel yourself!

Sources

• Renee Kam. “Exercise and breastfeeding.” Australian Breastfeeding Association. Australian Breastfeeding Association, April 2022. Web.
• Dewey KG, Lovelady CA, Nommsen-Rivers LA, McCrory MA, Lönnerdal B. A randomized study of the effects of aerobic exercise by lactating women on breast-milk volume and composition. N Engl J Med. 1994 Feb 17;330(7):449-53.
• Mayo Clinic Staff. “Exercise after pregnancy: How to get started.” Mayo Clinic. Mayo Clinic, July 27 2016. Web.
• “Exercise.” La Leche League International. La Leche League International, Jan. 2018 Web.

The American Academy of Pediatrics recommends that all healthy infants be put down to sleep on their backs, not their sides or stomachs.

Why should babies sleep on their backs?

This is the safest position to sleep for the first year of life, since it drastically reduces the chance of Sudden Infant Death Syndrome, often known as SIDS.

SIDS is one of the top 5 causes of death for babies under age one. However, the SIDS rate has declined by 50% since experts began recommending that parents place babies on their backs to sleep for every nap and overnight. While experts do not know exactly what causes SIDS, in addition to genetic predisposition, there may also be airway and awareness changes that make it harder for babies on their stomachs to get enough oxygen. 

Doctors used to believe that if babies slept on their backs, if they were to vomit it could cause dangerous blocked airways. Doctors later discovered that babies have little difficulty turning their heads while sick or spitting up, and leaving baby in a stomach down position is far more dangerous. If your newborn has a condition that forces them to remain on their stomachs, consult your pediatrician or family doctor about safe sleep positions. Infants who sleep on their backs are also less susceptible to ear infections, fevers, and stuffy noses.

Even if your newborn is sleeping on their back, it is important to avoid soft surfaces like pillows and comforters, stuffed toys, loose clothing, crib bumpers or any other potentially loose item (like mittens or hats) which can block the airway. A firm crib mattress covered by a tightly fitted sheet is the safest bedding for an infant, even if it seems empty in there! The AAP recommends that infants should be sleeping in their sleep space alone as well.

Parents and caregivers should place infants on their backs for every sleep. Once a baby can roll into their preferred sleep position, you do not need to reposition them as SIDS becomes far less of a risk. 

Reviewed by the Ovia Health Clinical Team 

Sources

• “Frequently Asked Questions (FAQs) About SIDS and Safe Infant Sleep.” National Institute of Child Health and Human Development. U.S. Department of Health and Human Services. Web.
• “Sleep Position: Why Back is Best.” HealthyChildren. American Academy of Pediatrics, November 21 2015. Web.
• “Sudden Infant Death Syndrome(SIDS).” Centers for Disease Control and Prevention. U.S. Department of Health and Human Services, October 3 2016. Web.

Traveling with your newborn

It’s true that Baby‘s immune system won’t be fully formed for a while yet, which makes the outside world little bit of a risk for them, but sometimes trips outdoors can’t be avoided. With the right precautions, though, stepping out with Baby can be safe, healthy, and fun for the whole family.

Make sure to pack these nine items for any outing, and go at your own pace — don’t let anyone else (except maybe the doctor) dictate what you can and can’t do with Baby.

1. Fully stocked diaper bag
   This should include key items such as diapers, rash cream, changing pad, wipes, a pacifier if Baby uses one, a blanket or two, and any other poop emergency necessities.
2. Feeding materials
   The obvious aspects of feeding may include formula, water to mix the formula with if it’s not already fully mixed, bottles, or a breastfeeding cover-up, depending on Baby‘s feeding routine.
3. Stroller and sling
   If you’re taking Baby for a short stroll, or even to a more crowded place, wheeling them around can be cumbersome — packing a sling for shorter or more crowded jaunts can give the two of you better ease of movement, and keep them close for comfort on these early trips. On the other hand, keeping the stroller on hand for longer outings can keep you both from getting tired out or uncomfortable to early on in your outing.
4. Water
   This is for you, not Baby, who shouldn’t start drinking water until they is around 6 months old. For you, though, it’s important to have some water handy to stay hydrated, especially if you’re breastfeeding, or going out soon after delivery.
5. Sunglasses and hat
   Baby shouldn’t be exposed to direct sunlight until they is at least 6 months old. Before 6 months, sunscreen is not recommended for babies. Making sure Baby is covered up with a hat and lightweight long sleeves is an important part of their sun-defenses. You can also bring an umbrella as a shade for Baby‘s stroller, carrier, or seat. Even after Baby hits that 6-month mark, and is old enough to squirm away as you try to get sunscreen to cover their face, baby sunglasses with UV protection can help to keep their eyes and face protected from harmful UV rays. This is especially important since even once Baby can wear sunscreen, it’s a good idea to be careful about putting it on the skin to near to their eyes.
6. Change of clothes
   This is mostly for Baby, but that doesn’t mean it isn’t a good idea to have a clean change of shirt for you around, too. You never know what sort of mess Baby could get themselves into, though, so you’ll want to pack a couple of extra pieces of clothing for them just in case of wet, cold, or mess.
7. Sense of humor
   Leaving home for the first time after giving birth can be a trying experience, so try to remain positive and laugh off any and all mistakes that are bound to happen. A great way to keep tension from getting too high on these early trips out into the world is to make sure to leave yourself plenty of time – maybe a full half hour just to leave the house, and then plenty of travel time in-between stops, if you’re planning a busy day.
8. Moral support
   Bringing your partner, a family member, or a friend along with you and Baby to keep an eye on them, or even hold onto them while you eat, use the restroom, or even just catch your breath a minute can be a great way to have a more relaxed outing.

Learn how to give a newborn a sponge bath

Doctors recommend washing newborns two to three times per week, so knowing the best way to give Baby a sponge bath is important, especially because newborns shouldn’t go all the way in the tub until their umbilical cords fall off.

Supplies

Before attempting to bathe Baby, make sure you’ve got all your supplies handy. Many parents choose to purchase a newborn bath, but an inflatable tub, a water basin, or even a well-prepared sink will do the trick. You will also need mild baby soap, cotton balls, washcloths, a towel, clean diapers, and clean clothes.

Giving the bath

1. Since you’ll be bathing Baby outside the tub at first, simply fill a bowl or the sink with lukewarm water and wrap them in a towel, then place them lying down on their back.
2. Dip a cotton ball in water and wipe Baby’s eyes, making sure to use a fresh ball for each eye.
3. Next, dampen a washcloth and wipe their face and ears, without using soap. Don’t forget their skin-folds, or behind their ears, but be sure not to wash or let water drip into Baby‘s inner ear canal.
4. Place a little soap on the cloth and wash Baby’s neck, scalp, and the rest of their body. They probably doesn’t have much in the way of hair yet, so rubbing a damp, soapy washcloth over their scalp should keep them squeaky-clean. Newborns who DO in fact arrive with a full head of hair could need a more thorough hair-wash, which you can read more about here.
5. There’s some divided opinion about washing Baby‘s umbilical stump, so check in with the doctor if you’re unsure, but generally, as long as the stump is clean, keeping it clean and dry and untouched by the sponge bath is the way to go. If there’s some crustiness, you can carefully wipe it clean with a clean, damp cloth, and then pat or air it dry.
6. Rinse off the soap and dry, rewrapping Baby with a towel. Baby‘s head is likely to get cold after a bath, especially if they has a luscious head of hair, so covering their head with a dry towel is a great way to keep them from getting a chill.
7. Some newborns come into the world with that fabled soft skin, but others are a little more sensitive, and bathing can dry sensitive newborn skin out even further. If Baby‘s skin is a little dry or peeling, if you want to, you can gently rub some mild baby moisturizer into their skin before popping them back into their onesie.
8. Put on a clean diaper and clothes, and resume cuddling!

Tips and Tricks

Make sure you never take your hands off Baby while bathing them. This is a great time to bond with Baby, so make sure to use it as a fun play-time, not just cleaning. Try dropping a little water on their tummy and watch the laughs roll in. Some newborns have a hard time with the cold, so only expose skin for short periods of time. Remember that Baby does not need to be bathed every day, because this can dry out their skin. You only need to give them sponge baths until the umbilical stump comes off, and then you can transition to the baby bath.

Sources

• Mayo Clinic Staff. “Baby bath basics: A parent’s guide.” Mayo Clinic. Mayo Clinic, October 25 2016. Web.
• “Caring for your baby.” March of Dimes. March of Dimes, 2017. Web.

How often should I feed my newborn?

A general rule of thumb is that newborns should feed at least 8 times in 24 hours. The appetites of newborns can vary, as some newborns might yearn for a meal just 90 minutes or so after their last, while others may wait up to three hours before requesting another feeding. Breastmilk and formula are helpful for hunger, but they are also there for thirst; there are actually so many reasons why a baby may show you cues! While it’s difficult to put a newborn on a true feeding schedule, a newborn should generally never go more than 3 to 4 hours without eating, including overnight, although your pediatrician or lactation consultant may have recommendations that are more specific to Baby.

Making sure to wake the Baby for feeds should continue for about the first two weeks or until your baby is back to its birthweight. At that time, your pediatric provider might okay slightly longer times between feeds if the Baby is sleeping at night, but spoiler alert—these are pretty rare. Babies have tiny tummies and need frequent feedings to stay hydrated, fed and comfortable.

Signs of hunger

Because on-cue feeding is generally regarded as the best way to feed a newborn, it’s important to be able to recognize the signs of a hungry one. These may include:

• Early signs: Opening their mouth, licking their lips, puckering their mouth, or turning their head ‘rooting’ for breast or bottle.
• Mid signs: Putting their fingers, fist or clothes in their mouth, sucking, restless movements, stretching, trying to lie in a ‘nursing’ position.
• Late signs: Frantic movements, crying.

Even if a newborn isn’t showing signs of hunger, it’s still important not to go more than three to four hours without offering them a feeding until you’ve gotten the all clear to do so. If you’re having trouble waking them, try a gentle diaper change and some skin-to-skin time. If they are so sleepy that they don’t reach at least 8 feeds in 24 hours, it’s important to let their provider know. 

While it’s tempting to start a schedule for feeds early on, this can negatively impact breastmilk supply for many people. Going too long between feeds can make Baby uncomfortable and frantically hungry, too. If the routine of feeding is feeling overwhelming, it can be great to get support from a lactation consultant or the reassurance and validation of a local parents’ group.

Sources

• Mayo Clinic Staff. “Feeding your newborn: Tips for new parents.” Mayo Clinic Staff. Mayo Clinic Staff, April 20 2022. 
• Jain, S and Bunik, M. “How Much and How Often Should Your Baby Eat.” HealthyChildren. American Academy of Pediatrics, April 2 2024.
• “Breastfeeding Info: Feeding Frequency.” La Leche League International. La Leche League International, https://llli.org/breastfeeding-info/frequency-feeding-frequently-asked-questions-faqs/