Well Baby Report - 1Month Guide

What to expect at your one-month visit
Here are a few things your doctor might discuss with you at the one-month visit.

• The umbilical cord and circumcision should be healed.
• Most babies are feeding well. Breast-feeding or the correct formula should be well-established.
• Expect crying to peak at about six weeks, then gradually reduce at about three months.
• Your baby is probably sleeping a lot of the time, but rarely for long stretches.

One-month immunizations
Hepatitis B virus (HBV) vaccine (#1 or #2) (1-4 mo), depending if given after birth or at two weeks

Today’s Report For Your 1-Month-Old

Child’s Name

Examined by Dr.

Weight

%

Length

%

Head

Immunizations

Milestones

Notes

Feeding your baby
Your 1-month-old will be getting all of his or her nutrition from either breast milk or formula. Infants can vary a great deal in how often they need to eat, with breastfed infants feeding more often. Babies who seem to be gaining weight and appear healthy are probably getting enough to eat. Another good indicator is a wet diaper every two to three hours.

Breastfeeding
You should breastfeed your baby every 2½ to four hours (about seven to nine times a day). Breastfeed for at least 10 to 15 minutes on each breast. Babies get most of the milk in the first 10 minutes. Your own nutrition is especially important to your baby. Make sure you are eating well, and getting enough rest and fluids. Try to make breastfeeding a relaxing time. If you run into problems breastfeeding, don’t give up right away. Talk to your health care provider about any breastfeeding concerns. Growth spurts do occur at approximately 10 days, three weeks, six weeks, and three months. During those times, you will need to breastfeed more often until your milk supply is increased.

Bottle-feeding
If you choose to bottle-feed, you should give your baby iron-fortified formula. Make sure your bottle-fed baby gets the same cuddling and holding during mealtimes as a breastfed baby does. Always hold the baby when feeding him or her. He or she needs the comfort of being held, and there is a possibility he or she could choke on the formula if the bottle is propped. Do not put your baby to bed with a bottle, it can cause choking and promote tooth decay once his or her teeth come in. To further prevent tooth decay, never dip your baby’s pacifier into anything sweet. Finally, to prevent burns, never heat your baby’s bottle in the microwave oven. Generally warm tap water will dissolve formula.

Developmental milestones
Keep in mind that children develop at their own rates. These milestones are common to infants at this age, but it is completely normal for your child to reach some quickly and others at a slower rate. Common milestones can include the following:

• Responds to sound
• Looks at human faces
• Follows face with eyes
• Responds to parents' voices and faces
• Briefly lifts head when lying on stomach
• Moves arms and legs
• Coos or makes non-crying sounds.
• Is more alert and aware of surroundings
• Sleeps for three to four hours at a time
• Stays awake for one hour or longer

Taking care of yourself
The first month of having a new baby at home can be quite overwhelming. It’s very easy to get caught up in the needs of your baby and forget about your needs, but this is an extremely important time to take care of yourself. Ask a family member or close friend to watch the baby for an hour or two. Sleep as much as you can. Try taking a nap when the baby is napping. Do not worry about the housework, laundry, or dishes. The time for you and your baby is far more important.

During the first few weeks after your baby’s birth, it is completely natural to feel out of sorts, blue, or even resentful of the demands your baby is making upon you. If you feel unusually depressed or unhappy, talk to your doctor. Postpartum depression is not unusual. If you feel so resentful of your baby that you are tempted to hurt him or her, contact your doctor immediately.

Sibling rivalry
Bringing home a new baby can effect the entire family, especially older children in the household. Learning to share his or her parents with a new brother or sister can be a painful process, but it is also a valuable experience for your older child. Here are a few suggestions for easing the transition:

• Spend time with the older child throughout the day-especially at bedtime.
• Buy the older child a doll to feed, diaper, or take care of.
• Purchase small gifts for the older child from the new baby, or just to have around the house. (Many people forget the older child when bringing gifts for the baby.)

• Keep your baby out of the direct sun. Do not use sunscreen until your baby is at least 6 months old.
• Car safety seats are always necessary. Place the seat in the middle of the back seat, facing backward. If you are unsure you are placing it correctly, check with your local health department or the manufacturer’s instructions for help. Never set the car seat in the driveway. If you carry the baby and safety seat inside your home, place the seat only on the floor.
• Place your baby on his or her back when sleeping.
• Install fire extinguishers and smoke detectors on every floor of your home, and make sure they are working properly.
• Do not leave your baby alone with a young sibling or a pet.
• Do not hold or drink hot liquids while holding your baby.
• Do not smoke around your new baby.

• Rattle, large rings, squeeze or sucking toys
• Lullabies, nursery rhymes, or poems
• Bright pictures of faces hung so baby can see them
• Cardboard or vinyl books with bright colors
• Brightly patterned crib sheets
• Mobile with parts visible from baby’s position

Should I call the doctor?
Yes. If your baby:

• Becomes sluggish or inactive
• Will not eat
• Cries more than usual
• Develops an unusual rash (not prickly heat or diaper rash)
• Has a fever at any age
• Vomits repeatedly (not just spitting up)
• Has frequent, loose, watery bowel movements
• Has apnea spells (times when baby stops breathing for long periods)
• Breathes rapidly, wheezes, or has any difficulty in breathing

Before you call your child's doctor or nurse, write down your child’s symptoms. Take your child’s temperature. Have your pharmacy’s phone number on hand to tell the doctor. Keep a notepad on hand to write down any instructions.