Baby Steps: Getting Ready for Your Newborn’s Arrival

Kirsten Robinson, M.D., Texas Tech Physicians pediatrician, discusses essential preparations for new parents. Dr. Robinson advises starting prenatal care early, optimizing health conditions, and taking prenatal vitamins. Key items for newborns include a safe sleep environment, a car seat, a thermometer, basic care items, and a pediatrician. To prepare siblings and pets, she suggests reading books and gradually introducing them to the new baby. Dr. Robinson emphasizes the importance of safe sleep practices, avoiding overbundling, and recognizing signs of illness. Regular pediatric visits are crucial, with the first at one to two weeks post-birth.

Transcript

Melissa Whitfield  00:09

Hello and welcome back to Texas Tech Health Check from Texas Tech University Health Sciences Center. I'm your host, Melissa Whitfield. We want you to get healthy and stay healthy with help from evidence based advice from our physicians, health care providers and researchers. We all know that parenting doesn't come with a guidebook, but there are sources available to help new parents prepare for their little ones. Kirsten Robinson, pediatrician with Texas Tech physicians, spoke with us about what soon to be parents can do to prepare for their newborn. How do you prepare? You don't have to buy the latest or most expensive gadgets, but Dr. Robinson does have several recommendations to keep your baby safe and healthy. If you're not expecting a baby anytime soon, please feel free to share this episode with any friends or family who might be.

Melissa Whitfield  01:09

Dr. Robinson, welcome to our podcast. 

Kirsten Robinson, M.D.  01:12

Thank you. Thank you for having me. 

Melissa Whitfield  01:14

Thank you so much for coming on. And can you just tell our listeners a little bit about yourself, your expertise and what you do here at the Health Sciences Center.

Kirsten Robinson, M.D.  01:21

Absolutely. My name is Kirsten Robinson. I am an associate professor in the department of pediatrics. All of my clinical work is in the newborn nursery at UMC. I serve as the medical director for the Family Care Unit and family care nursery at UMC.

Melissa Whitfield  01:37

Well again, thank you so much for coming on our podcast, and I have to say, I am in awe of anyone who is going to go on this journey, but we're going to talk about newborns. I myself only had one and was scared after that, but I think if people are better prepared, it'll help a little bit. So ideally, when should parents start getting ready for their newborn, and what are the top, let's say five things they should try to have ready before the baby is born.

Kirsten Robinson, M.D.  02:07

I mean, in an ideal world, we would like to start getting ready before you're even pregnant. Obviously we want to start taking prenatal vitamins, and those are important for folic acid. And you know, if you drink socially, or, you know, smoke or vape, we want to try to discontinue all of those things before pregnancy. That's in an ideal world. If you are already pregnant, you want to establish care with a OB-GYN or family medicine, who does both family medicine and OB to start prenatal care as soon as possible. And so the earlier, the better. We want to optimize any health conditions that you might have if you take regular medications for chronic medical condition. You want to make sure that those things are in the best possible care and that your medicines are at the right level. For example, if you have thyroid issues and you take hypothyroid medication, you want to make sure that those all your hormone levels are at a good level, so following up with your primary care physician. Also, during your pregnancy we offer, here at UMC, childbirth education classes. Those can be accessed through UMC's website. The same also holds true. At Covenant Children's they offer preparatory childbirth education classes at their campus as well. You can prepare for childbirth, learn about breastfeeding and they also offer baby care basics classes. So if they, if you don't have any experience taking care of newborns, they will get you ready with all of the basic things that you need to know just about basic newborn care. When it comes to the top five things to have ready, first and foremost, you want to have a safe sleep environment for your baby. You want your baby to have their own crib or bassinet. We'll get into a little bit later, kind of the safest places for baby to sleep, but having a safe sleep setting. We want to have a car seat ready to go home. And there are lots of good options at all different price points. You don't need a car seat that has the most bells and whistles. All of the ones that are on the market are really, you know, crash tested and are safe. You want a five point harness. You can go to Walmart, Target, you can go online to and order one there too. But just having a car seat ready, babies should be in a rear facing car seat until they're at least two years old. You want to have a thermometer at home. It doesn't have to be a fancy thermometer, just your simple digital reading thermometer is fine. We don't really recommend the ear thermometers or the forehead thermometers in a brand new baby anyway, so you can stick to your very inexpensive pharmacy thermometer without any problems. And then you want to have some basic care items. You want to have diapers, wipes, just some basic clothing. Newborns actually don't need a whole lot. They need to be warm and fed and clean and they're good to go. Actually, there are a lot of things that make it seem overwhelming, but it actually doesn't have to be super overwhelming. And the last thing is, you really want to figure out who your baby's doctor or care provider is going to be. So you want to talk to your OB, talk to your friends about what pediatrician that they use for their baby, and kind of get some ideas, and call around in town and find out who is accepting your insurance and is taking new patients, and get a care provider established. If you come to the hospital to deliver and you haven't figured that out yet, we will help you. So it is no stress. There's no crazy questions. We're happy to answer all of them. We'll help you get set up with a pediatrician if you get to the hospital and you haven't picked one out yet.

Melissa Whitfield  05:48

How can we prepare other siblings for the baby's arrival? And do we need to prepare pets for the baby as well?

Kirsten Robinson, M.D.  05:55

So as far as siblings goes, a lot of that depends on the age of your other children. I feel like talking about the newborn that's coming, kind of what they can expect, asking what questions they have. Reading books is a really great way to prepare. There's a lot of good stories out there and just, you know, going to the bookstore, looking online and finding one that fits, kind of fits your family. There's a lot of good stories that will help. Letting them help pick out items for the baby, and kind of talking about, you know, what babies need when they're born, and just involving them helps take some of the unknown out of it. As far as pets, getting them used to all the items that you have, like the car seat and the clothes, let them kind of explore. And you want to make sure your pets up to date on all their vaccinations also. And just when you do bring baby home, getting, letting your pet get used to the baby. We don't recommend right away that you leave them unattended with each other. Same goes true for siblings, actually. We're just watching and but letting them smell, experience the baby, listen to the baby cry. Most pets adjust to new babies in the family very well, and so just watching them closely and generally it's okay.

Melissa Whitfield  07:18

What are some things that we should include or exclude when preparing a nursery?

Kirsten Robinson, M.D.  07:25

So, I think it's important to say that a basic setup is absolutely okay. We make the sort of the business of having a new baby a major ordeal, and it actually doesn't have to be. So having a safe space for the baby to sleep. In the beginning, it can even just be a bassinet that you're bringing you don't even have to buy the full crib yet. It's going to be a little bit before they're big enough to be in that. So if you have a bassinet that can be in your room. The safest place, we do recommend that babies sleep in room with parents in the beginning, if possible. That allows you to be close and hear your baby and be able to get to them quicker at night, and it's just less stress if they're right there. You get to know their cues, and they get to learn you as well. We want to have some sort of diaper changing area. I think it is helpful in the beginning to kind of have a small basket or a bin that you have sort of the essentials that you might need. You don't want to have to be finding things in the middle of the night. You want to make it as easy as possible. So having some wipes and diapers and any diaper cream if you're using it, some alcohol swabs, you know, just some basic things right there that you can keep all together. If you have a changing mat that you can put down. It is nice in the middle of the night, if you have a little mat you can put down if you're changing your baby on your bed, that way, you're less likely to have a whole wet the bed experience and be changing your sheets in the middle of the night.

Melissa Whitfield  08:56

You mentioned having a bassinet in the room with the parents. Is it safe to have a baby sleep in the same bed as mom and dad?

Kirsten Robinson, M.D.  09:03

We don't recommend sharing a bed with our baby, and we also don't recommend that the new baby sleep in bed with siblings either. Our bedding and mattresses and pillows are not really designed for infants, and it really increases the risk of sudden infant death syndrome. And so the safest place for them to be is their own crib or bassinet. So alone in their own crib or bassinet and on their back with no extra fluffy blankets or pillows or stuffed animals or anything in the bed with them. It should be pretty boring in their bed. You can do a sleep sack or a swaddle blanket that is, you know, allows some movement of their legs. But we don't want to have anything that could end up around their face or inhibiting the air flow around their face, that could end up in their face and them not be able to breathe.

Melissa Whitfield  09:59

How soon can we take a baby out in public?

Kirsten Robinson, M.D.  10:04

You know, there are some seasonal considerations with this, and also, it also depends on your family makeup. If you have other kiddos, your kiddos gonna go, your baby's gonna go to daycare. We do the best we can with what we have. So in the beginning, up to the age of two months, baby's immune system is really not functioning at the same level as an older child or an adult, and so they are going to be at more risk for infection. And we take infection very seriously in newborns, so some families will want to just kind of stay put and keep baby out of the public until they've had their first set of immunizations at two months, just to decrease the likelihood of infection. That's not reasonable for everybody, and we want everyone to do the best they can. So under two months of age, we do consider fever an emergency. So any baby who has a fever 100.4 or greater in that first two months of life, we're going to recommend that they go to the emergency room and be seen immediately, even if it's in the middle of the night or on the weekend. If it's during clinic hours, you can call your pediatrician. They are very likely to direct you to the ER for a full evaluation so that we can assess and make sure there's not a serious infection going on. At two months, babies get their first set of shots, and their immune system is a little more mature, and so that risk goes down a little bit. If you have older kids, if you've got family things going on and you need to take your baby out in public, just limiting their exposure as much as possible to people who are sick. So good hand washing for all the adults and older kiddos. If you have family or friends that even have just a cold or allergies, people like to say they have a lot of allergies, let them come love on you later. Like we have lots of time to meet baby. We are coming up on holiday gatherings where people don't want to miss and so they'll kind of come even if they have a little cold. A regular kind of a run of the mill cold for an adult can be very dangerous for a young infant, and so I would just be very careful over this holiday season and let, let the family and friends who might be a little bit under the weather come love on you later. 

Melissa Whitfield  12:19

Do we need to keep babies bundled up year round? I sit by a window and I see a lot of babies coming to our clinics, and they're bundled up year round. 

Kirsten Robinson, M.D.  12:28

They are. You know, some, some of that is different cultures view how to dress a baby differently. Really, for newborns, if we're looking at very young infants having a hat on when they're out and about, you know, just a regular newborn cap, kind of helps preserve that heat. They really only need one extra layer than we do. Some of that depends on the size and how big your baby is. When you're traveling with your baby in the car seat, you can kind of tuck blankets around them. The biggest thing is, we want to dress them safely. We don't want any big, bulky sweaters or coats while children are in car seats. So you'd want to dress them just in their clothes in a light layer and then cover them with a blanket to keep them warm. We do have to be careful covering the car seat with a blanket. In the summer, it can actually get extremely hot in the car seat. When you think you're protecting your baby from the sun, it's actually trapping the heat inside, and it can get dangerously hot. It also doesn't allow air flow to circulate very well. So if the wind is blowing, keeping the cover, but don't cover for very long. But really, at home, whatever temperature you keep your house, your baby might need one extra light layer. As you get your baby home, you will kind of get to know the, the natural temperature of your own baby and kind of determine if they run like maybe they do need an extra, you know, a little bit thicker layer and a sleeper, or if they actually seem to be doing just fine in a thin sleeper and a blanket. But overall, most babies don't need to be over bundled. And that can even be a little bit dangerous. If we over bundle them when they're sleeping, they can overheat, which also increases the risk of SIDS or sudden infant death syndrome, so.

Melissa Whitfield  14:11

how often should we schedule visits with a pediatrician? And how can we tell when a baby needs to go to the ER? 

Kirsten Robinson, M.D.  14:17

So when you come in to deliver your baby, we will recommend, when you go home from the hospital, you will have a weight and a color check looking for jaundice, anywhere from one to three days after you go home. That's sometimes we offer those back here in the nursery, or we'll set you up with your doctor to go for that. That's a quick visit just to make sure everything is going okay. The first official visit is when your baby is one to two weeks old. They'll be weighed, get a full exam, we'll do the second state newborn screen, which tests for a lot of genetic and metabolic conditions. The next one is at two months, and then that begins our regular 2, 4, 6 months, 9 months, 12 months. That's kind of the first year. And every time you go to the doctor, we will make that next well check before you leave. When you have a young infant, things you're going to be watching out for. How you're going to know if your child needs to be seen, either at the doctor or go to the emergency room. Certainly, as we talked about any fever in a newborn over 100.4 we would want them to be seen right away. Once they get over that two months of age, your pediatrician will give you guidelines of what to watch for, as far as temperature, and we can be a little bit more lenient, and have you just go to your pediatrician's office instead of the emergency room. You want to make sure that your baby is having enough wet and dirty diapers. That varies a little bit on age two, and we'll guide you on that as we need to based on the age of your baby. But if you're concerned that your baby is dehydrated, they're not wetting enough diapers, they're vomiting and they can't keep any fluids down, those would be times we would want you to seek care in the emergency room or with your pediatrician. In, we are in cough, cold, flu, RSV season. So when we're looking at a young infant and breathing difficulties, if they are breathing more than 60 times a minute, it is helpful to watch that on a watch, because often we think they're breathing faster than they are. But more than 60 times a minute or they're working extremely hard to breathe. They are making grunting noises when they're breathing or they are, like when you look at their chest, the skin is sinking in between their ribs. Those are called retractions. Those are signs that we would want your baby to come right away to the emergency room. Certainly, if your baby's color doesn't look right, they look blue. We definitely in that situation, we would want you to call 911. Don't try to bring your baby to us, just call 911 and let us come to you.

Melissa Whitfield  16:51

What are two or three pieces of advice that you have for new parents?

Kirsten Robinson, M.D.  16:57

I think first and foremost, give yourself some grace. This is a very big life change. And also trying not to make it too complicated. You will have many people in your life that try to give you lots of advice on what they think is the very best way that you should raise your baby, and all the things to do. If you have the basics down and you are feeding your baby, and they are wearing clean clothes, and you're changing their diaper, and they're in a safe environment. Get those basic needs met. There are a lot of different ways, and they're all just fine, and so you'll figure out a way that works best for your family. The other thing I would say, take care of where you're getting your information from. We live in an age where you are just flooded with information from all angles in the media, social media, the internet, it's very easy to find information, and it's difficult to filter what actually is good, solid, correct information and what is misinformation. And so you want to watch your sources carefully, because it's very difficult to know who's telling you things that are actually not maybe the best advice. So that's where talking to your pediatrician, your care provider for your baby, your obstetrician when you're pregnant. And then making sure, if you're looking online, that you're looking at resources that are up to date, that are providing you the best possible information. The American Academy of Pediatrics has a parent side of their website called healthychildren.org and they have a wealth of information. Their search function is very good, and you can look up symptoms, you can look up common questions and really get a good answer.

Melissa Whitfield  18:44

You've given us a lot of great information and advice. Is there anything else that you would like to add?

Kirsten Robinson, M.D.  18:48

I think it's also important. There's a lot of changes that go on when you're adding a new baby to your family, and so taking some time for yourself and making sure that you are reaching out for help if you're experiencing any symptoms that you might be thinking or postpartum depression or postpartum anxiety. Those things are very common and you don't have to suffer through those things alone. Your OB provider, that's something we'll give you resources on at the hospital, reaching out to friends. We want you to lean on your network and reach out for help if you think that that is going beyond kind of the normal baby blues, so that we can come alongside and help you through that.

Melissa Whitfield  19:31

Well, thank you so much for coming on our podcast, and as I said, giving us all this great information and advice and tips. Thank you.

Kirsten Robinson, M.D.  19:38

 Absolutely, thanks for having me. 

Melissa Whitfield  19:39

Can't wait to have you back on 

Kirsten Robinson, M.D.  19:40

Absolutely I'd be happy to come back. 

Melissa Whitfield  19:42

Thank you for listening to Texas Tech Health Check. Make sure to subscribe or follow wherever you listen to podcasts. This information is not intended to be a substitute for professional medical advice. Always seek immediate medical advice from your physician or your health care provider for questions regarding your health or medical condition. Texas Tech Health Check is brought to you by Texas Tech University Health Sciences Center and produced by TR Castillo, Suzanna Cisneros, Mark Hendricks, Kay Williams and me, Melissa Whitfield.