Dr. Karie Button (Host): Welcome to For Peds Sake, the podcast where we bring expert insights, heartfelt patient stories, and practical tips for parents and caregivers. I'm your host, Dr. Katharine Button, and today, we are diving into a topic that's incredibly exciting and one of my favorite topics in pediatrics, newborn 101. Whether you're expecting your first child, adding another little one to your family, or supporting a loved one through this journey, we've got you covered.

Joining me today is Dr. Melanie Suaris, a pediatrician here at Nicklaus Children's who sees patients at our primary care pediatric locations in Cutler Bay and at Nicklaus Children's at Galloway.

Dr. Suaris, welcome to the show.

Dr. Melanie Suaris: Thank you so much, Dr. Button for having me. I'm excited to talk about everything newborn.

Host: Great. Let's start with the basics, Dr. Suaris. What are some of the most common things new parents should expect in those first few days after bringing their baby home?

Dr. Melanie Suaris: The first few days with the newborn are really a whirlwind. There are a few things I just want the parents to expect. In short, it's mainly how are we going to feed the baby, how are we going to make sure that the baby gets to sleep, how are we going to change them, and what to do when they're crying or other changes that are going on.

First and foremost, let's talk about feeding, that's usually a big high stress point for any sort of new parent. Newborns typically eat every two or three hours, whether breastfeeding or formula feeding. I try to counsel the parents that I see in the office, that they should be looking for feeding cues. Things like rooting, sucking on their hands, these are all good signs that it's time to feed. In the beginning, babies are usually very sleepy after being born. My general rule of thumb is to feed the babies any time they are showing those signs of hunger that I just mentioned. Sometimes this can be every two hours or even every 45 minutes, if you could believe that, while they're cluster feeding. But every child is different. Whether or not this is your first child or second child, it's not a one-size-fits-all. But generally, as a pediatrician, in the first few weeks of life, I like for the baby to be fed at minimum every three to four hours.

And now sleeping, if it's not feeding, stressing out the parents, it's going to be sleeping. So, newborns sleep a lot. They sleep almost about 16, 17 hours a day, but it's broken into short stretches, short periods of time. Sometimes they'll give you a two-hour nap. Sometimes they'll only sleep for 45 minutes. It's really unpredictable. I try to tell parents that there is no schedule. It's only a routine that they should be following in the very beginning.

The first few weeks is especially tough because they may have their day and nights confused. I tell parents all the time that what we want is the moment they bring their baby home, we want there to be a clear difference between night time and the day time. So during the day, I say let's keep those lights on, let's open up the windows, make even a little bit of noise. But then at night, I want there to be some sort of wind down period, maybe a little cozy bath, a warm bottle, a dark room with or without a sound machine. But, in general, remember parents, frequent awakenings is very common, and basically nothing that you guys say to each other after 2:00 a.m. really counts, so give each other some grace, okay?

The next thing is diapers. Expect a lot of wet and soiled or dirty diapers. It's normal for a newborn to have six to eight wet diapers a day and multiple bowel movements, especially if they're breastfeeding.

And when it comes to crying, which is a very common thing that I hear in the office, or even when I used to work in the emergency room, a very common complaint is, "I don't know why my kid is crying. I don't know what's going on." A quote I find myself saying a lot to myself as a new parent is, "The baby is not giving me a hard time, the baby is having a hard time." And I think that helps new parents put that into perspective. Just imagine being born and nobody is understanding what you want. Over time, parents will get to know what each cry means and it really does get easier.

I want to reassure every single parent out there that it's okay to put the baby down in a safe space if you need a moment for yourself. Hearing the crying can be very overstimulating and frustrating. But if you need five minutes alone in like a bathroom, just take it. Be the best version of yourself in order to be the best version for your baby. With that being said, follow your gut. If the crying is just unlike every other like hunger cry or tired cry, something that you're truly not used to, that's when you should be talking to your pediatrician.

And lastly, one of the other changes that we kind of see in the very beginning are skin changes. In the first few weeks of life, you may see different skin changes from peeling or acne, most of which is benign and goes away on its own. But don't worry, you're going to have frequent follow up with your pediatrician in that first month, even first year of life. So, they could always weigh in if something doesn't seem right to you.

Host: Thank you so much for that, Dr. Suaris. That is really helpful information. I know a lot of parents worry about whether their baby's eating or not. If a child is eating enough or if something's actually wrong with them when they cry and how they can know whether there is something wrong, what advice would you give to ease these concerns for parents?

Dr. Melanie Suaris: Firstly, remember that it's normal to feel uncertain at the beginning. Both you and your baby are adjusting to this new phase of life. Trust your instincts and know that you're doing great. If you're breastfeeding, tracking diaper output and weight gain during the pediatric visits will be very reassuring. And when it comes to crying, sometimes babies just need to be held or rocked. But don't hesitate to reach out to your pediatrician if you're ever really worried.

The pediatrician's best friend is the growth chart. I think we definitely overestimate the amount a baby should be eating. There is no magic number of ounces at a certain age that works universally. I have infants ranging from 1 oz every 2 hours to 3 oz every 2 hours. But if they are growing well, not fussy, just follow the cues of your baby. As mentioned before, you know your baby best and you're going to get to know all of their cries and all of their needs. Follow your gut. If you feel like something is wrong, please call the pediatrician. We are there for a reason, and trust me, we really do want to know what's going on.

It's also important to mention that your OB will ask that you choose a pediatrician for your child before you give birth. Here at Nicklaus Children's, we have several pediatric primary care locations with wonderful pediatricians that you can meet before your little one arrives to ensure that you feel comfortable and confident with your child's doctor. As a shameless plug, I do work between the Galloway and Cutler Bay location, so I'm happy to see any kids out there.

Host: Perfect. Now, speaking of pediatricians, what are some of the key milestones or health checks that parents should be prepared for in those early weeks?

Dr. Melanie Suaris: Here are the big ones. So, the first pediatric visit is usually within two to three days after the hospital discharge. Many hospitals, especially down here in South Florida, won't even let you be discharged after giving birth without that initial pediatric appointment. So, that's why finding a good pediatrician before is a good thing to do. There will be weight checks with the pediatrician to ensure that your baby is gaining weight appropriately. We'll also be checking in for newborn screening results. When the baby is in the hospital, they're going to take a little sample of blood and there's a blood test that's done within the state of Florida to test for different medical conditions. So, we'll follow up that result.

And then, of course, last but not least, there's going to be vaccines. The first hepatitis B vaccine is given in the hospital. And then, in the following months with the follow up with your pediatrician, there will be a certain schedule.

Host: These are such important reminders. Thank you. Now, let's talk about something really important. Self care for our parents. While welcoming a newborn into the world is so incredibly joyful, it can also be extremely exhausting. What advice do you have for parents to take care of themselves during the transition?

Dr. Melanie Suaris: I had mentioned kind of something earlier that if you're not the best version of yourself, then there's just no way you could be the best parent for your baby. Many people out there are just going to say, rest whenever you can, sleep whenever the baby sleeps. As a new-ish parent, my second child is currently about 10 months old. That's a lot easier said than done, especially if dad works, if there's a bunch of bottles to be cleaned, lots of laundry. So, I don't really necessarily say sleep whenever the baby sleeps, but just rest. You know, making sure that you try to just get a little bit of peace whenever you have those short periods of time when the baby is resting. Make sure that you're staying very hydrated and nourished. I know in those beginning weeks and like the first couple of months, all of the attention is geared towards the baby. But especially, as a new mom, not much attention is given to the mom herself. So, make sure that you're prioritizing water. You are prioritizing eating. It's okay to put down the baby. The baby will be just fine if you take a few minutes to yourself. And especially true for breastfeeding moms, a crucial part of breastfeeding is to stay hydrated. So, that's just another incentive to always make sure that you get your cute water bottle always, you know, chugging around with you.

Share responsibilities, communicate with your partner. I can't stress this enough. Whoever is helping, the mom or the dad taking care of the baby, you guys are a team. Do not keep a scorecard. Some days, it's going to feel like 50/50. Some days, it's going to feel like 70/30, 80/20. At the end of the day, you guys are 100% there for the kids, okay? And be gentle with yourself, especially for new moms. There's a lot of mom guilt. There's a lot of just feeling like, "Am I doing the right thing?" I mean, believe me, I'm a mom to two kids. And despite being a pediatrician, I definitely doubt myself almost on a daily basis. But there is no perfect recipe, but just know that you are the perfect parent for your child. Just give yourself grace. No one knows what they're doing to be completely truthful. We're all just kind of just figuring it out as we go along.

And something that I wish I did more, especially with my first kid, was just to not hesitate to ask for help. As a new mom, as just a new parent in general, you feel like you should be kind of the only one who's able to take care of the baby. But just know that, if you're lucky enough to have a village around you, make sure that you are leaning on them. Postpartum is very emotional, it can be a very stressful time. So, make sure you just lean on other people to help make you through it.

Host: That was just so beautifully said, Dr. Suaris. Thank you. The message of parents being able to give themselves grace with newborns at home is so important. So, thank you for that. Before we wrap up today, do you have any final tips or words of encouragement or wisdom for our listeners?

Dr. Melanie Suaris: Again, just remember that whether or not you're a first time mom, whether or not you're about to give birth to your fourth child, every baby is different and your family is going to continue to grow and to adapt. You celebrate your small victories. Don't compare your child to anyone else. Don't compare your breastfeeding journey, your feeding journey to your friends, to anyone else. Everyone is so different. This is such an individual experience. Cherish the early days. Now, that I have also a toddler, I feel like I'm getting to enjoy the newborn stage a little bit more, which is nice. And I guess that just comes with a little bit of experience. Just enjoy every little bit of it.

Host: Perfect. The message is soak it up. This is such wonderful advice. Thank you, Dr. Suaris, for joining us today and for sharing your expertise.

Dr. Melanie Suaris: Thank you.

Host: And thank you to our listeners for tuning in to For Peds Sake. If you found this episode helpful, please subscribe, leave a review, and share it with other parents and caregivers. And join us next time for more insights and tips to support your parenting journey. Until then, take care.