Please use this guide to help answer questions about common concerns about your baby or child's care.   We are always available to help you, but ask that you consult this guide before calling after hours about non-urgent problems.

1.      Newborn feeding

We recommend that newborns be breast fed whenever possible.  If you chose to use formula or need to supplement with an infant formula, Similac with iron or Enfamil with iron should be used in most cases.  It does not matter whether you use powder, concentrate, or ready to feed.  If there is a strong family history of allergy to cow's milk or a milk protein intolerance, a soy formula such as Prosobee or Isomil should be used.  "Low iron"  formula should never be used.  Water supplements are usually not necessary.

People often wonder how much their baby should be drinking.  There is large variation in what an individual baby will drink and how often.  See our attached breastfeeding guide for breast fed babies.  Formula fed babies should be given bottles with one ounce more than they usually drink, so that if they are ready to have more it is available.  They should not be pushed to finish more than they want. Generally, babies will drink about 2 to 2 1/2 ounces per pound (body weight) of formula per day (24 hours).

2.      Colic

In the first three months of life babies often cry for no apparent reason.  This crying is most likely to occur in the late afternoon, evening or nighttime.  You should call us if your baby has a fever, looks weak or sick, or has a cry significantly different from any she has had before.  Fever is a temperature of 100.4 rectally or higher.  A rectal temperature is the most accurate.  It is taken by lying your baby on his belly and inserting a glass or digital thermometer into the anus until the metal tip is buried.  A digital thermometer will indicate when it done measuring.  A glass thermometer should be kept in for at least one full minute

Before assuming that your baby is just being colicky, assure yourself that your baby is not hungry. A breastfed baby who is hungry may act like she wants to nurse, but then pull away from the breasts if your milk supply is low. You can try a supplement, preferably with previously pumped breast milk.  If this stops your baby's crying, you may need to find ways to increase your supply at this time of the day.

Is your baby constipated?  See section on constipation.

Is there something causing pain?  Look your baby over from head to toe.  Sometimes a hair has become wrapped around a finger, toe, or penis.  Check that there is no bulge in the groin that could be from a hernia.  Check that socks are not too tight, etc.

Iron in formula does not cause colic. Low iron formulas do not have enough iron to allow your baby's brain to develop normally, so do not attempt to treat colic by switching from an iron to a low iron formula.

Some colic may be caused by discomfort associated with normal digestion.  Some people find that using Chamomile Tea can help this discomfort.  Giving an once of this tea a few times a day may be helpful.

If your baby looks well, but is crying inconsolably there are several things you can try.  Colicky babies often need to be walked and patted for hours at a time.  They have a physical need to be close to someone's body and be in motion.  This can be normal.  Some people find it easiest during these times if they have a chest pack in which they can strap their baby  (such as a Snuggly).  That way the baby is consoled, but the parent still has his hands free.  Some babies do well in swings or seats that vibrate.  Some babies need to be swaddled tightly.  Many babies are soothed by white noise, particularly the sound of running water. See if it helps to stand near a faucet with the water running.

Some babies cry inconsolably when they are overtired.  They know that they feel uncomfortable, but don't know how to relax and fall asleep.  If you have tried all of the above, it is time to try putting your baby to sleep in a dark, quiet room and letting him cry for 5 to 10 minutes.  Many babies will suddenly fall soundly to sleep, and that is what they needed all along.