One of the first questions new parents ask me during the first week or two of babyâ€™s life is â€œCan we take the baby out?â€ Often there is a grandparent in the background urging home detention for the newborn. Is this necessary? The answer is a qualified â€œno.â€ Getting out of the house once Mom is feeling like the â€œduck waddleâ€ is gone is good for both baby and parents. There is nothing harmful about getting fresh air and exercise. Bear in mind certain caveats:
Â·Â Â Â Â Â Â Â Â A full term baby has some temperature instability (when he or she gets a little chilly and needs extra blankets) for the first forty eight hours after birth. A premature baby may continue to have temperature instability for a longer period of time; premature babies are kept in temperature controlled isolettes in the nursery until they are able to maintain their temperature.
Â·Â Â Â Â Â Â Â Â After the first few days, the baby is able to maintain his temperature, but during a walk outside, he will be stationary while the parents may be mobile. Add an extra layer of clothing to the baby to compensate for this if temperatures are cool or cold.
Â·Â Â Â Â Â Â Â Â An easy way to see if the baby is too hot or too cold is to check his hands and feet. If they are blue or cold, add another layer of clothing or a blanket. If the baby feels hot and sweaty, take off a layer.
Â·Â Â Â Â Â Â Â The biggest risk to an infant in the first six to eight weeks of life is infection. A newborn receives antibodies across the placenta from the mother, but these antibodies are only effective against infections the mother has had. These antibodies are temporary and begin to wane during the first year of life.
Â·Â Â Â Â Â Â Â While the newbornâ€™s immune system is still immature, it can be helped by breast feeding and avoiding infection during the first two months. The best way to do this is to have everyone wash their hands before touching the baby and keep young children or anyone with an infection away from the baby.
Â·Â Â Â Â Â Â Â If a newborn gets a fever (101.4 rectally) during the first two months, doctors must aggressively evaluate the baby and may need to do blood and urine tests (and occasionally a spinal tap) to look for bacterial infection. The reason for this aggressive response is that babies can get sick quickly and it may be hard to tell a simple viral infection (such as a cold) from a virulent bacterial infection.
Â·Â Â Â Â Â Â Â Avoid groups of humans who may be inclined to â€œkootchy kooâ€ your baby without washing their hands.
Â·Â Â Â Â Â Â Â Keep a hand sanitizer with the baby at all times, whether inside or out. When a well-meaning friend or relative wants to hold the baby, you can blame your pediatrician on insisting on hand-washing.
Â·Â Â Â Â Â Â Â Another frequent question from new parents is, â€œCan we fly to India, Mozambique, Singapore, Seattle, Los Angelesâ€¦.with our baby?â€ Ideally, it would be best to wait at least until the baby is eight weeks old for the reasons discussed above. Viruses can exist on seat fabric, tabletops, and blankets for an extended period of time, and we are all familiar with the airborne viruses from the recycled air on airplanes that have us sneezing and snorting on return from a trip. Many parents today, however, do travel with their newborns to see ailing family members or excited grandparents. Parents must weigh the risk of the baby picking up a virus against the gain the trip presents.
Â·Â Â Â Â Â Â Â At two months of age, your baby should get the diphtheria, pertussis, tetanus, hepatitis B, and the polio vaccine (Pediarix).
What do you think? Have you found baby joggers, bjorns, portable car seats/day beds liberating? Do you shudder when you see an infant on a plane? Do you think we are becoming germ-obsessed with our little bottles of hand sanitizers?
Dr. Victoria McEvoy graduated from Harvard Medical School in 1975 and is currently an Assistant Professor of Pediatrics at HMS. She is the Medical Director and Chief of Pediatrics at Mass General West Medical Group. She has practiced pediatrics for almost thirty years. She has been married to Earl for thirty six years and raised four children. She currently enjoys writing, traveling, reading, almost all sports, and spending time with her two grandsons.
Eat, Play, and Be Healthy
Parents are often bombarded with new information on childrenâ€™s nutrition, and as a result, the most important dietary considerations often get lost in the mix. From Harvard Medical School, Eat, Play, and Be Healthy offers guidance on healthy eating through the various stages of childrenâ€™s lives, from infants to eight-year-olds. From breastfeeding to school lunches, get the tools to put your child on the path to a healthy adulthood.