Talk With A Doc

Talk With A Doc: Lifecycle: Health For A Better World
Episode 03: Healthy Beginnings: From Birth to Baby Steps

Dr. ALex Hamling
There are sleep sacks. There are attachments that you can add to your baby to monitor blood pressure or the way that they turn. I think the pendulum swung too. We have too much technology in the sleep baby world. Finding a bassinet that has good appropriate side walls that your baby won't tumble one way or the other. A firmer mattress in the sense that they won't accidentally sink their head into a plush pillow top, or to an extra pillow, and then having tight fitting sheeting. Around the mattress that fits into that crib and bassinet. Appropriately so. Infants do not need extra pillows. Do not need extra stuffies. In fact, I would say less stuff in the crib, the better.
Jennifer Semenza
Hello and welcome back to talk with the docs Lifecycle: Health for a Better World. Our goal for this series is to help boost your know how so you can take charge of your healthcare and enjoy better outcomes and quality life. For all your healthcare. Visit providence.org to find general practitioners and specialists in your area and the latest in healthcare news. In our previous two episodes, we discussed good prenatal care and what to do if you're suffering from more serious symptoms like gestational diabetes or preeclampsia. In today's episode, we'll go over what you need to know once the baby has arrived, like milestones, nutrition, immunizations. And what to do if your baby is sick or colicky?
I'm your host, Jennifer Semenza and here with me today is Doctor Alex Hamlin. Let's get started. Doctor Hamling, thanks for joining us.
Dr. ALex Hamling
Thank you, Jennifer. Thanks for having me today.
Jennifer Semenza
Absolutely.
I adore babies and I'm the mom of two and a newish grandma. My grandson just turned 1 and I can't help but be excited about this topic. Watching him grow and kind of hit those early milestones has been a real joy, but it's been a while since I had a newborn of my own, so I'm really curious to hear about the. Best practices compared to when? Raising my kids. So let's start off with one of the first big decisions parents make.
What advice would you give to prospective parents when they're looking for a pediatrician? And how important is it to have the right pediatrician?
Dr. ALex Hamling
Thanks Jennifer, for a great question. You know, I talk with a lot of families that are pregnant through the Providence medical group at Providence Everett Medical Center and some of the main advice. I'd love to give with families is, you know, #1 find a provider that takes. Insurance. This is going to be a person that you're going to go to often and you don't want to get. Just for not having the right insurance, I think #2, you know, find some place that has good hours that meet your schedules as well too. And then lastly, the most important thing is that this is a person that. You're going to be asking questions of that you are going to be receiving advice from, so you want to make sure that they kind of gel and jive with you, that this is a person that you feel you can truly trust to grow with with you and your. And that you feel very approachable to with asking any sorts of questions as well.
Jennifer Semenza
That's really good advice. What are some of the questions that parents should be asking when they're considering a new pediatrician?
Dr. ALex Hamling
Absolutely. I think some basic questions are, you know, what is your pediatrician's philosophy on vaccinations? What is your pediatrician's philosophy on? Well, child visits? How easy or hard is it to get a same day appointment, either with your pediatrician or another member in their practice? If your child is sick, then lastly you know are there after our lines and numbers to call. If it's the weekend, if it's a holiday, if you. Travel.
At Pacific Medical centers, you'll provide 24/7 care with our nurse triage line, so we make it easy. The families just have to know one phone number, and that's the number that they call day or night. They get my nurse, who's in clinic with me all day long or or after hours nurse who gets great advice over the phone, and then we follow up with the next business day.
Jennifer Semenza
I wish that would have been available when I was raising kids that would have made things so much easier. Let's chat about caring for a. I know that this is an area that really terrified me when I was a first time mom. I routinely had bad dreams that I would misplace the baby or make some other ridiculous mistakes. And I'd. Willing to bet that other parents have those same experiences? So let's start with. Day 6 and go right into feeding.
Dr. ALex Hamling
I mean the basics are, you know, feeding, sleeping, changing. And not being stressed out, right, like once you connect to those four, you'll have all the pillars for the rest of your life. Unfortunately, for most parents, it takes a good 18 years to get them down to feel comfortable into with it.
Jennifer Semenza
I have a 30-year-old and I'm still figuring it out.
Let's do start with feeding that infant so we know that breastfeeding is more beneficial than formula. Why is that?
Dr. ALex Hamling
We know that breast milk is best in the sense that this is what Mother Nature intended, that infants thrive on the mixture of. Of sugars of fats, of proteins of macro micronutrients, of probiotics, of bacteria. All these things that are colonized on our skin that are made through breast milk and that an infants body is designed to digest, to break down, to grow, to put that energy where it needs to.
So for growth. For weight gain for brain development, for development in general, with the children as well. We also think that formulas next best step. Don't get me wrong, there are some families who either choose not to breastfeed or are not able to. Or there's a medical condition for an infant that breastfeeding would be more dangerous. And in that case, formula is a great second option.
Also a great supplement for certain infants that may be preterm born early. Who we call small for gestation wage, meaning that they're light, that they just need those extra calories and breast milk by itself may not be able to provide that. We utilize breast milk as. Our mainstay recommendation, but with full knowledge that formula is a very acceptable reason and for some events that's the only option that they have for. So that's where good pediatrician can help guide give your family good advice. Talk with you about all the different products that you see on the shelves at Walmart there.
Dr. ALex Hamling
Which one is the best to go with?
Jennifer Semenza
Yeah. And thank you for for mentioning that there are some people that breastfeeding just isn't an option for them for a variety of reasons. Reasons. But those families, how do they select an infant? Because you're right, there is a wall full of choices when you get to the store.
Dr. ALex Hamling
Yeah. And I would say that a lot of this starts with good prenatal conversation. This may be conversations with your OB, GYN or your midwifery group. This may be conversations that you have with a prenatal consultation with a pediatrician or family medicine doctor before your baby's born. And also good discussions after your baby's born.
If you're in a birth center or a hospital. That you know, you're talking with the rounding nurse practitioner, pediatrician, midwife about those very specific needs, and if there are additional test studies that your baby may need, or if anything was observed prenatally that may need to be given advice for so. In general, otherwise healthy.
Full term, no issues with pregnancy or delivery. Going home with Mom and Dad. Know a few days after birth. The basic standard Similac, Enfamil, Gerber are all great options even. The grocery store. I know that they sound like they're the cheapest. It's really all the same stuff that's put into it, just a dollar cheaper.
Jennifer Semenza
Great. So for people who are choosing to breastfeed, what if they're having trouble getting their milk to drop, or their body doesn't seem to be making enough milk? There anything you can do to help in? Of those situations.
Dr. ALex Hamling
Yeah, a lot of this comes down to making sure that families have good resources with lactation consultants in our area. Virtual lactation consultants to provide good support to schedule visits in person or virtually. In addition, you know I do several different procedures in our clinic, including tongue ties and lip ties for those infants that really just don't have. Have the right mouth anatomy to get a successful transfer of milk from moms breast to their stomach.
Jennifer Semenza
And what about some of the other issues like pain, engorgement or mastitis? What can you do to lessen those symptoms?
Dr. ALex Hamling
Absolutely. So on the moms part, you know, engorgement is just kind of entrapment of milk that's not able to come down. The collecting tube can cause pain or discomfort for for a lot of moms can lead to mastitis if it's untreated. Basically a bacterial infection up the M. And into the memory ducts. Warm. Heat packs at home before breastfeeding are a great easy start. Utilizing either a hand pump or an electric pump. Breast pump are great options for helping to relieve to open up any of that flow to unclog anything from the mammary gland and out through the ******, and then saving that great breast milk for delivery to their infant at a later time.
Jennifer Semenza
Great. Is there a standard on how often and how much you should feed your baby?
Dr. ALex Hamling
In general, you know, we say about 8:00 to 12:00 feeds and a 24 hour period. Doing the math, that's on average for a newborn about every two to three hours. Hours. Most newborns you know. Once they developed a good habit of feeding. Both parents have developed a good habit of recognizing with their infant. It's about a 20 minute process.
You know, sometimes it's one side, sometimes it's both sides depending on kind of a mother's production or feeding with a bottle with express breast milk or formula. And I would say that the probably the most important factor is monitoring. Your baby's output, the amount that they pee, the amount that they poop. I wouldn't say that it needs to be graphed or you know in. Charts. Things like that, but in general he about once. Once with every feed to every other feed is a pretty good. Pooping about once a day for breastfed babies is pretty typical and normal, although that can be highly variable as well.
Jennifer Semenza
Yeah, I'm sure. Talk to. A little bit about how to recognize hunger signs versus just. Fussy baby noise. Often times I think that you know the first reaction is to to stick something in their mouth to stop the. Are there differences actually between what those hunger cues are versus just regular fussing?
Dr. ALex Hamling
Absolutely. A lot of times I tell parents they just kind of go down through your mental checklist. Was the last time you fed your. Has it been in that two to three hour window? That may be a good sign. Is your baby's diaper. Does it smell like they have a lot of pee, a lot of spool? That can be very irritating to babies. Are you watching your baby's face and their demeanor? Are you reaching for? Reaching for your breasts? Are they putting their hand in their mouth as good signs? They are showing hunger? Views and kind of walking through that step list is kind of a nice easy way to check the easy things of, Oh yeah, we didn't change your diaper yet on the last two hours. We got a big piece today, all right. You know, let's do. And, you know, soothing comfort your baby first in that sense and then offer food when the time is right.
Jennifer Semenza
That's great advice. So let's switch gears a little bit to sleeping and safe sleep practices. So today's conventional wisdom is having a baby sleep on their back, which is the exact opposite of what I was advised 25 or 30 years ago. Why is sleeping on back import? Part.
Dr. ALex Hamling
Absolutely, babies, when they sleep on their back, they have all the air. The world to breathe. Babies who are on their belly. A lot of. Newborns especially just don't have good muscle control. Good muscle strength of their head, muscle neck, muscle, shoulder muscles. So for them. Into a pillow A. The the firm mattress that you may have in your crib or bassinet poses a suffocation hazard as it presses up against their nose, up against their mouth.
Whereas if they're on. Again, it's easy for them to turn their head a lot less resistance. Have all the air in. World to breathe. Unfortunately, yes, there are cases of what we call SIDS. Setting them and Death syndrome, where infants may be placed on their stomach and parents are not observing this and wind up passing away while they're asleep. So. Putting babies on their back to sleep, having babies sleep in. The main bedroom with mom or dad for the first six months has drastically reduced the cases and incidences of SIDS across the world.
Jennifer Semenza
That is great to hear. What should we know about betting and and what should babies be? And now they have these sleep stacks, which that's not something I had with my kids. Is that really what we should be using now instead of betting? What do you advise?
Dr. ALex Hamling
It's a great. You know, I mean, yes, there are sleep sacks. Are weighted. There are attachments that you can add to your baby to monitor blood pressure. The way that they turn, how often are they being active? I think the pendulum swung too. We have too much technology in the sleep baby world for me. I think that finding a clue or bassinet that has. Good appropriate side. You know that your baby won't tumble one way. The other. Firmer mattress, in the sense that they won't accidentally sink their head into a plush pillow top or into an extra pillow, and then having tight fitting sheeting around. The mattress that fits into the crib and bassinet appropriately.
So infants do not need extra pillows. Do not need extra stuffies. In fact, I would say less stuff in the crib, the. Again, all of that can pose a risk for something to be accidentally knocked down, placed upon their head, and infants don't have the coordination, muscle strength knowledge that their hands connect their body and how to push something away from their mouth or face. And may pose a suffocation risk.
Jennifer Semenza
What's a normal amount of sleep for an infant in a 24-hour period?
Dr. ALex Hamling
Yeah, infants are going. Spend a majority of their day. You know, 12 to 16 hours is not. Waking up for 20-30 minutes to feed the marathon work for most babies. That. That sucking, swallowing, breathing time during breastfeeding. Bottle feeding. And so that he need their rest as well for recovery and growth and development. So it's not unusual that they'll sleep for more hours out of. Day than not.
Jennifer Semenza
And they're my. It seems like they only slept during the daytime when I was awake.
Dr. ALex Hamling
Routines exactly. So you know, encouraging kind of cluster feeding, feeding a little bit more frequently in the daylight hours to hopefully get that nighttime to stretch out to that full three hours. Or your rasp for your partners. Rasp for anybody who's helping in the household.
Jennifer Semenza
Yeah, great advice. This is talk with ad life cycle and I'm speaking with Doctor Alex Hamlin, a pediatrician with Pacific Medical Center, about caring for your newborn through the first couple of years to help keep them healthy and happy, new parents might be hearing a lot about sleep training. How import? Is a sleep routine.
Dr. ALex Hamling
I think a sleep routine is great both for parents and for. I think routines are great for kids in general, so sleep routine is just one of the many. Going to do something similar with feeding with activity with. Play. So when I say sleep routines, we're thinking about going to bed around the same time, getting up around the same time having habits that encourage sleep, decreasing the light in your baby's room, maybe turning on a white noise machine. Not having a lot of distractions from cell phones. Alarm clocks that may be going on. So this helps. Number. As a parent, prepare the routine of knowing what's going on, whether we're doing bath and reading in bed or reading in bath in bed. And it helps the child as well to get into that group, and knowing what to expect as a new norm for them.
Jennifer Semenza
Yeah, that's useful. What about sharing a room with the parents or? Are there special things to be aware of? If that's the case?
Dr. ALex Hamling
Yeah, in general we talked about, you know, reducing SIDS and some great studies out of New Zealand has really showed that sleeping with the baby in the room in their own crib and bassinet has drastically reduced SIDS. Some families who choose to do Co sleeping or a side bed for convenience and ease. Don't recommend that. Personally myself, I think that they can pose a risk. Of infants tumbling off the bed. Somebody rolling on to that area of a bed or attachment area or extra pillows getting tossed over. So I don't think there's anything wrong with sharing a. I think just making sure you do it with safe sleep practices with infants with their own separate crib and bassinet that's appropriate for their age, size and weight.
Jennifer Semenza
Yeah, yeah. And and I think the question that every parent wants to know at what point do babies typically start? For the night.

Dr. ALex Hamling
Right, I I wish I could tell you exactly 6 months. That's when T being happens and then they got mouth pain all night, and then it just kind of throws a wrench into the whole cycle and everything else. I would say that babies who sleep through the whole night tend to have good routines. You tend to have parents who also get good rest and sleep and have. Sleep habits as well too. So practicing a lot of these habits together as a family makes that transition easier.
Jennifer Semenza
Great bonding and kind of the emotional well-being of infants is really one of those things that we're hearing more about. And I know a lot of new parents are worried about. With their baby. What does that mean and why is that important?
Dr. ALex Hamling
Yeah. When we talk about bonding, this is the emotional attachment to infants. Is the physical touch with infants. This is the time where I really recommend for both moms and dads or couples to have a structured carrier. A mobi wrapped sling, a time to practice that skin to skin time. A time to sing, to talk to your baby, to have good, positive touch, you know, on their hands and top of their head. To encourage all the. Development and attachment that you're trying to impart with this baby, more so than just the necessity for food and energy, but to provide the love and care and support that goes along with it as well too.
Dr. ALex Hamling
It's great if you have grandparents that can come over and help and be part of that as well, but. Time for for new families to really kind of spend time with their baby.
Jennifer Semenza
Yeah, and let's chat also about how to communicate with your newborn and and kind of, you know, understanding what they need because it can be really frustrating if they're crying and you can't understand what it is that they're needing. What are the ways in which newborns communicate their needs and wants?
Dr. ALex Hamling
Great. Yeah. So I often tell families as new parents. Your baby is communicating perfectly well to you. Just don't understand it. That's. They speak their own language. They have their own desires, needs once and for some reason. As competent adults, we can't understand that. It's a job to problem solve that. So again, having mental checklists has it been that time for feeding? You crying for? Are you too hot or too cold? Are you? Is the ambient temperature in the room or went out for a hike in the snow? Know affecting how your baby may be feeling? Other things like checking their diaper.
Making sure they're. Are they gassy from a big feed that you didn't get a good burp from the last one and they just feel like they have a lot of belly? Comfort and need to be propped up right and some good burping. Or need a nice little belly massage. So these are all good ways of kind of again you can talk with maybe you can, you know say maybe I don't know what's bothering you, but I'm going to try everything I can to help you and kind. Go. Your list,
I often tell families. The way babies learn is through hearing words and so. When you're at the dinner table and your baby's with you and you're talking about how good this broccoli is and how great the broccoli was, flavored and tasted. And we've said broccoli. 3. That's really important for your baby and. If it's hearing that word repetitively. So you as a new parent, it's really weird to talk about broccoli three times, but get used to it because that's how your baby is going to pick up the nuances of our language, of knowing names, of knowing what we call things in this world.
Jennifer Semenza
What about for parents who feel like their baby isn't communicating or responding? You know normal or or typical pattern. When should they have them checked out to see if something's really maybe going on developmentally? Maybe they're just developing in a slower than average pace. What should they having that conversation?
Dr. ALex Hamling
Great. So I would say, you know, these are perfect conversations to have with your pediatrician or family medicine provider that you see and it's recommended using the bright futures guidelines as far as you know, seeing babies about two days after discharge from the hospital by about two weeks of. 2469 months, 12 months, and so it you actually have a lot of opportunities and touch points with. Nutrition to bring up these questions or concerns. Number one for your pediatrician to assess your child as far as their growth, their development, their weight through standardized screenings, through communication and talking with family members through pre visit forms. And if you're still worried and concerned, yeah, we have a great overlapping national program. The birth, the three program early intervention that is a free number for families to call to have an assessment done specifically for those concerns, you know. And I often tell families if. Have a worry call the number. Schedule something on your own time and come to your house. Have a question about the way. They crawl the way that they are using one hand or the other, or they're just babbling and not putting words together. When you think they need to. And kind of go from there.
Jennifer Semenza
And we'll be sure to include that in the. Notes as well. Perfect. So I know that. There's a phrase I've heard called purple. I've heard that mentioned recently for new parents. What is purple crying and how can they? For it.
Dr. ALex Hamling
Yeah, the purple crying is in a reference to the color of your baby's face from being overly angered, crying so much that not that they're forgetting to breathe, but that they just have a little bit of trouble. We oxygenating because they are just so. Basically, it's a breath holding and they are getting anger and worked up and a lot of times it scares parents because they're worried that something's wrong with their baby. Something's wrong with their baby's breathing. Something's wrong with their baby's heart. In general, this again is your baby expressing his or hers desired needs once, and we're not smart enough to. And so sometimes again going through those checklist kind of taking a mental break as a parent and just taking a breath. Saying. Know what? My baby's. On the back or in the crib and giving them a hug. I love them. I'm trying to learn what's best for them and I'm having a tough time understanding my baby of what's, what's going on and going from there. You'll find that, yeah, sometimes these babies will basically just cry and cry and cry and. Get purple in the face.
Jennifer Semenza
Let's switch gears a little bit and talk about hygiene for infants. I know that good hygiene for for newborns has really changed. Do you have any tips or hacks you can offer to new parents?
Dr. ALex Hamling
I mean, I'd say coming out of the KOVAT pandemic and. Flu season that is upon us continuing to practice. Hand hy. Washing continuing to avoid people who you know are sick. Asking people if they want to come and visit and they know they have a cold or cough. Them to come back in a week or. It's okay. Your baby is going to be just as cute for them. Just as adorable and you'll have a lot less worry about transferring. Respiratory viruses like flu, kovid, rhinovirus and other kind of GI viruses as well too.
Jennifer Semenza
All those things we want to avoid.
Dr. ALex Hamling
Correct. So you'll be mindful if your surroundings of your environment. I think doing general pickup and cleanliness, sweeping, vacuuming, cleaning, countertop surfaces, high touch areas that these are where a lot of virus particles like to live and land. So just doing your due diligence of wiping them down as you would. Your house or in? Car or when you're entering into grocery stores or. Like that.
Jennifer Semenza
Great advice. Let's chat up a little bit about bathing. I think that bathing a newborn can be really scary for new parents and it's it's one of those areas where the guidance has really changed over the years. When should a newborn receive their first bath, and how often should they be bathed?
Dr. ALex Hamling
Yeah. So you're right, the the guidance, you know all babies seem to get a hot water bath before they left the hospital and the nurse would go in there and do it and show you exactly what to do. Now we've kind of swung the other way. That says, well, that natural coating that the baby has a vernex is healthy bacteria. Healthy. It's healthy in the sense that it helps colonize their GI TR. Maybe we don't want to wash it off right away, so a lot of times I tell families, you know, use your nose, use your best judgment. Your baby smells. That's a great time to get the sponge bath out to get the washcloth out. You don't need a lot of water. It doesn't need to be terribly. It just needs to be warm enough that you feel comfortable holding your baby in the water and scrubbing those areas that. Generally get dirty like the diaper area, like around the mouth or neck where your baby may have some extra spit up or drooling. Keeping those areas kind of clean and dry. Your baby is not running. They are not working out in the yard digging. They are not sweating in the normal areas that most adults do. So just being mindful kind of you know, OK, I think it's time for for a nice bath and make it a positive. Both. Your baby and for yourself too, that this is again is another quality bonding time that everybody can partake in and family.

Jennifer Semenza
That's. And bath time is also fun as they get older. That's yeah, you're. It's a great bonding time. Let's check out some of the notable milestones we need to pay attention to for our newborns. Imagine there's different physical and cognitive and and kind of social milestones. Be paying attention to.
Dr. ALex Hamling
Absolutely. And again, these all come about with the normal natural development of your baby's brain and babies are. There's some thought that they should have maybe needed an extra trimester in the womb for development, and they don't have great muscle. Most babies don't realize their hands connected to their body, and So what actually hit themselves in the middle of the night and wake up and wonder. Did that baby's muscle strength through their head muscles, neck muscles, truncal muscles for sitting up just take time to develop, you know? Some of these happen in the first few months, some of them take six months or nine months. Longer to develop. And again, these are the times. Where through the well child. Through those repeated visits with your pediatrician or family medicine doctor that you will have great touch points opportunities to bring up any concerns that you've noticed for your provider to be able to address anything that he or she has noticed on exam or through history. And kind of following along with things like that.
Jennifer Semenza
What if they're not hitting? Those typical milestones in the right time frame when. A parent seek help.
Dr. ALex Hamling
Yeah. So again, I'd say. Yeah, if you're concerned or worried as a parent, great time to call the nurse triage line to schedule an appointment with your pediatrician to call early intervention and just have that conversation. It's bothering you if it's sitting in the back of your mind. That's a perfect time to bring it up. You know, I often tell families, you know, I see your kid for 1520 minutes. Every few months, you. Them 24 hours, seven days a week. So you're gonna notice something way before I do, but it's helpful if you're able to document what you notice. If we can reproduce it. Clinic helps me to say Yep, this can be normal or you're right. This is kind of on the further than delayed schedule and I'd be more worried about. Let me provide you with some opportunities phone numbers to call the next steps for referrals and things like that.
Jennifer Semenza
Great. How often should we be taking our babies in for a checkup?
Dr. ALex Hamling
So again, you know the standard is kind of that two days after discharge about two weeks, two months, four months, six months, nine months, a year. You know, you're looking at about 7 visits or so in that. 12. So it's on average, it's about once every two months and then spaces out a little bit to once every three months. And once every six months. And eventually, you know, as kids become three and four years. We'll see in a year. I'll see you at your next birthday and I would say let your provider. Guide you on. You know, I'd make it a point that when families are seeing me for their well child visits, that we schedule the next one before they leave the office. They can look at their calendar. Can look at. We know you know when our clinic is open and the hours and feel confident that families will come back and have that Peace of Mind, that if there are new questions that arise in that time frame that they can write them down, they can keep a track on. Log or Journal on their phone. And we'd have an appropriate time to discuss them.
Jennifer Semenza
That's great advice to to schedule it before you leave the office, because I imagine it's a lot easier to remember an appointment that's already set versus remembering to schedule one later. This is talk with the doc lifecycle coming up on our next episode drive. Hamlin will return to tell us what milestones your preschooler may be hitting, what to do if they're not, and to give us some tips to make sure your little one stays healthy. So let's talk about. When should you start immunizing your? And what if somebody wants to wait until they're older, or forgo them all together?
Dr. ALex Hamling
Yeah, great. So we highly recommend getting the immunizations on time in the appropriate time frame that they're recommended from the CDC from the ACIP, from the American Academy of Pediatrics.
For most infants, this means that hepatitis B vaccine soon after birth, the next round of vaccines, is generally around the two-month Mark 4 month Mark. Month mark. Really lining up well with when we want to see you back for your well child visits to check growth, to check development. So we kind of make it easy on families in that sense. There are some families who do choose to have alternative schedules, different schedules decline. Have personal experience or family members with experience of vaccine? And that's a great one-on-one conversation with your pediatrician or family medicine provider as far as what is the risk to my baby? Are the benefits. What could be next steps that we can do? Some families who want are worried about a number of needle ******. Are others who worry about the number of? And you know, we work with families individually and we kind of figure out okay if you want to come back at once a week for the next 4 weeks to see my nurse and just get one vaccine done. And every time. Great. We'll make that. It's it's a lot of car trips for you and yeah, we're happy to, to help guide you in that service and go.
Jennifer Semenza
That's great here. And we know. Just babies getting sick is just part of life that I know. It's hard for families to. Watch. Go through that because they feel so helpless. How should a parent know when they need to take the baby in to see somebody like you and somebody from your team?
Dr. ALex Hamling
Yeah, it's a great. So I often tell families that their kid is ? gonna have about 400 different cold coughs, runny noses, ear infections before they go to 1st grade. That's about one a week, and that's not unusual. That is just human nature. And the world that we live in and the viruses that like to. Attack us, but this also means then through grade school, through high school, as adults, we're not missing work or school or play that frequently because we've had all of our exposures at a young age, harking back to, you know, new families, they're worried. Concerned, I would say that based on your child's age is probably where I'm going to see a change of different red flags. So. Less than four weeks old, who have. 38�C or one oh point 4 Fahrenheit or. That's a pretty much don't pass go, go right actually to your emergency room. It's a bigger work up. Know where often looking at babies and assessing for. So checking to see if there's any bacterial infection in blood, the spinal cord area, and your baby's bladder and kidney area and often requires one to two days of. Babies that are older, young infants that are older than that, older than four weeks, six weeks. I would. That again, using your personal mommy daddy. Radar, is this seem unusual? My child acting very. Is my child acting extremely fussy? Is Tylenol not working well for them? Do I need? That's the perfect time to say great. Earnest triage line. My nurse bugs me all day. It's the after hours. The after hours nurses do a great job giving advice. The next business day to say hey, how are things going where you at? Would say that time is often a big. Helper in helping both families and pediatricians decide on what to do next to it's very hard when I hear, you know, my baby has a fever. For the last three hours versus this is the fifth day, my. Had a fever. Now I'm thinking very different things, so the timeframe. That I get to kind of piece more things together is also helpful and helps me decide what that next course of action should be. For your child and for. Family.
Jennifer Semenza
You mentioned 400 coves by a certain age and boy is that ringing. My my grandson just started daycare, and I think he's had a different daycare cold every week since he started and he's so generous to share with his mom and dad and me. So.
Dr. ALex Hamling
Exactly.
Jennifer Semenza
Let's turn our attention back to the birthing persons health and well-being. We know that both postponed depression and anxiety is not uncommon. What are those symptoms and how can they affect the moms physical well-being?
Dr. ALex Hamling
But we often talk about, you know, when you're introducing a new baby into the household, that there's a lot of change of routines, a lot of change of expectations for moms, for dads, for other kids who may be in the house. Really, a lot of this discussion starts before the baby is born. Setting up those expectations of who's going to be responsible for doing nighttime feedings. Who's going to be responsible for doing the grocery shopping? There are other kids. How can they be helpful in the? Well, when we see families for those well visits again in our clinic, what we like to do is ask the moms to fill out postpartum depression screening questionnaires. We look at them as pediatricians and family medicine doctors to help us decide. Know is this the normal typical baby Blues? Change of. Feeling that the routines are just overwhelming? Or is it moving to true depression or postpartum depression, where we can then, you know, offer resources, sending families back to their OB gyn, their midwife, one of our health care providers in our clinic. To start appropriate treatment or medications to kind of. Move forward and it's not unusual to kind of have either a mom or a dad or grandparent or another caregiver in the house kind of feel left out, neglected, lonely at times. Again, good discussion beforehand, setting up those new norms that will happen with the new baby, and then reevaluating as time meets, because expectations will change. Needs will change for everybody in the household as well as people will take time off of work, go back to work. Daycare needs to be involved or not. There's a lot of changes that happen in those first few months that families may not. Be able to fully plan for, but should be knowledgeable about and being willing to have those conversations as adults.
Jennifer Semenza
That's great advice to have those discussions ahead of time too. What are some of the? Health issues that birthing people should be aware of that might arise for them after they give birth. What can or should they do if they're experiencing any of those symptoms?
Dr. ALex Hamling
Yeah, a lot of. Most births here in America are happening in. Where there's good observation of the birthing parent by nursing staff, by physicians. There are some options of birthing centers or home births, and this is where it really comes down to having a good birthing practitioner. Whether that's a midwife and OB GYN and being able to kind of talk with them about what expectations can be for that type of birth. So whether? There is excessive. What can we do about? Whether there are medications that needed to be stopped or started during the pregnancy and when to change? Those what to do with your next follow up. When should that birthing parent see their provider next? Sure, they get that scheduled on the books. And then of course with our clinic families have. Worries. Yeah. We invite you to call, utilize our nurse triage system, and then we're able to help direct the appropriate care where it needs to be.
Jennifer Semenza
As we wrap up this discussion, is there one piece of advice that you give to all new parents?
Dr. ALex Hamling
One piece I would say is try not to stress out. Which is really hard to take because every family is already at the top of their. So I'd say, you know, if it feels like you're doing it right, you probably are. If you think you need to add more technology, you need to add more. Apps. You're probably doing it wrong because I say that kids need laps, not apps, and that's what I want most to focus on too. That babies come out nearly perfect every time, right? And that your job as a parent is to love them and feed them and care for them. And as long as you're doing that, you're probably doing it right. We can handle everything else on our end.
Jennifer Semenza
I love that, laps and not apps. That was great advice. We covered a lot today, but is there anything you think is essential that we didn't touch on that you want to make sure that the parents have as far as the information and guidance goes?
Dr. ALex Hamling
Again, I'd say for expecting parents, making sure that you kind of know which practice or which provider you plan to take your child to. So that way it doesn't feel like such a rush during the birthing process during the birthing time. And lastly to you know, a lot of families do develop a grand birthing plan. They want candles in the room. Soothing music. I say that's great to have that written out, but also be prepared to throw that out in case something changes with your birthing process, and that's where your healthcare providers will help guide that to make sure you have a safe. Healthy. Delivery and safe and healthy baby at the end of the day.
Jennifer Semenza
Doctor Hamling. This has been a really insightful. Thanks so much for making time to join us today.
Dr. ALex Hamling
My pleasure. Jennifer, this is wonderful.
Jennifer Semenza
Thank you for joining us on talk with the docs lifecycle help for better world. We hope our insights on caring for newborns and infants has been valuable. This joyful time can be challenging and we aim to support you in your parenting journey. Join us for our next episode, where we'll talk about establishing healthy habits. Training when and what screenings you should consider for infants and toddlers. To get continued information on other important healthcare topics, please subscribe to talk with the doc on your favorite podcast platform. You can connect with us on Facebook, TikTok and X at Providence. And on Instagram and LinkedIn, under Providence Health systems. For additional information about this and other health related topics, please check out the Providence blog at blog.providence.org. To learn more about our missions, programs and services, go to providence.org. Download the Providence app to access all this information and more. And remember the information provided during this program is for educational purposes only. You should always consult your healthcare provider if you have any questions regarding a medical condition or treatment. Thanks for listening. Here's what's coming up on our next episode.
Dr. ALex Hamling
So this is where I take real good advantage of our library. You know, I've taken both my daughters to many of the different infant reading times and toddler reading times and arts and crafts that exist in your local area. Pretty much all libraries have some access. Or sections of children's books, whether they're board books or easy reader books. And these are great that you can take your child there and make it an adventure, you know, let's find a book that has the color red on it. Find a book that has horses on it and start their excitement for literature.