103 - Two Weeks Old

Your baby is now two weeks old and they are changing so fast! In this episode, Dr. Carole Keim MD walks you through what to expect during your baby’s two-week check-up. Your baby will now be keeping their eyes open longer and the nighttime feeding schedule will change. She talks about tummy troubles that usually start to pop up over the next few weeks.

There is so much happening in that little body. Your baby is learning to use their muscles and oh wow that ceiling fan is so wonderful to look at. From tummy time to bicycle legs and what is safe to give your baby to help them along. 

Baby is starting to be awake more during the day - awkward age: (00:23)

Parents / emotions: (00:53)

• You’re getting a little more sleep - baby’s consolidating feeds, more awake during day, sleeping at night
• Don’t overstimulate
• Narrate your day

Eating: (01:54)

• 8-12x per 24h; formula or EBM should be 12-24 oz per day (350-700ml)

Peeing/pooping: (02:20)

• Baby pees and poops every time they eat

Tummy troubles: (02:55)

• gas, colic, reflux
• Gas/colic: belly rubs, bicycle legs, up and downs, tiger in a tree pose, tummy time, simethicone drops, probiotic drops
• Reflux: Explain LES, normal spit ups.  Signs of severe reflux: weight loss, spitting up more than half of their feed every time, arching back and screaming, aspirating (choking/coughing/sputtering)
• Pyloric stenosis: getting progressively worse, turns green (grass green)
• Reflux tx: smaller and more frequent feeds, hold upright for 20-30 mins after feeding, sleep in a reclined position (tilt the crib or bassinet with a phone book), NO pillows

Skin: (08:25)

• Umbilical stump is off - start baths.  Once or twice per week, unscented soap or just plain water, pat them dry rather than rubbing, use lotion/cream/ointment right after the bath
• Diaper rash - if it lasts more than 2-3 days despite normal diaper cream (zinc-oxide-based like Desitin or petroleum-based like Vaseline or Aquaphor) it might be infected.
• Candida (yeast/fungal) - solid pink area with tiny pinpoint-sized pink dots around it (satellite lesions). Can try mixing apple cider vinegar and water 1:1, OTC antifungal cream, or call a doctor for a prescription for Nystatin.
• Bacterial infection: pimples or boils, often MRSA, can try applying Neosporin TID but if it doesn’t help, they need mupirocin TID.  Treat the whole family - nails and nose.

Checkup: (12:42)

• Check weight, should be above birth weight now
• Ask about any feeding difficulties; should be better now
• Jaundice should be gone
• Screen for PPD
• PE: same head to toe exam as the first checkup
• Neuro/devel: Reflexes (grasp, suck, moro), calms to parents’ voices, communicates needs, lifts head in tummy time

Safety: (15:37)

• Fever over 100.4 (38c)
• Back to sleep, alone, in a crib or bassinet. Ok to stop swaddling and start sleepsack.  NO blankets til age 1 and no pillows til age 2.
• Never leave baby on high surfaces
• Avoid secondhand smoke
• Rear facing car seat til age 2 years
• Breastfeeding moms should be taking PNV
• Supplement baby with 400 IU vitamin D
• Tummy time: 2x per day 15-30 mins

What to expect in the next 2 weeks (before the 1mo checkup): (17:53)

• Awake more and more; start to notice things farther away like lights, windows, and ceiling fans
• Discoordinate stooling

Resources discussed in this episode:

• The Baby Manual - Available on Amazon

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