Page 1

We l c o m e to Ru b P e d i a t r i c s , M . D . , P. A . , a dy n a m i c Pedi a t r i c pra c t i c e wit h ser v i c e s to hel p yo u r inf a n t , chil d an d / o r ad o l e s c e n t gro w an d de v e l o p in th e ye a r s to co m e . We are deli g h t e d to inf o r m yo u th a t we ha v e offi c e s loc a t e d at Nor t h Sho r e Me d i c a l Cen t e r in Mia m i an d at Av e n t u r a Hos p i t a l in Ave n t u r a , Flori d a to be t t e r m e e t yo u r ne e d s . As yo u mi g h t alr e a d y kn o w , Ru b Pedi a t r i c s , M.D., P.A., co n si s t s of ph y s i c i a n s , an ci ll a r y pra c t i t i o n e r s , an d a co m p l i m e n t a r y sta f f th a t will hel p an d assis t yo u wit h yo u r chil d ’ s he a l t h ne e d s . Th e firs t he a l t h y ne w b o r n visi t is be t w e e n 2 da y s an d 4 we e k s of ag e , us u a l l y at 7 da y s of lif e, unl e s s th e ba b y ha d m e d i c a l issu e s or pro b l e m s at th e ti m e of birt h in th e ho s p i t a l or bir t h i n g ce n t e r at wh i c h ti m e an ap p o i n t m e n t wo u l d be ap p r o p r i a t e an y w h e r e be t w e e n 2- 14 da y s . Ret u r n offi c e visit for ne w b o r n s are in 4 we e k s , un l e s s m e d i c a l issu e s aris e . Pre m a t u r e or inf a n t s wit h m e d i c a l ne e d s will be see n on a we e k l y basis or m o r e fre q u e n t l y as ne e d e d .

6.

Pay th e re q u i r e d co- pa y m e n t s an d de d u c t i b l e s at th e be g i n n i n g of th e offic e visi t (u p o n re g i s t r a t i o n ) ; If yo u r ins u r a n c e do e s no t co v e r th e ser v i c e s , ple a s e pa y for th e ser v i c e be f o r e th e offi c e visi t ; Th e cale n d a r ye a r for m o s t ins u r a n c e s sta r t in Janu a r y .

7.

You M U S T en r o l l yo u r ne w b o r n to yo u r poli c y . You r ne w b o r n is no t au t o m a t i c a l l y ad d e d . For gro u p co v e r a g e , co n t a c t yo u r hu m a n reso u r c e s offic e . For in d i v i d u a l co v e r a g e , co n t a c t th e ins u r a n c e co m p a n y dir e c t l y . Th e n , co n t a c t th e ins u r a n c e co m p a n y on e we e k lat e r to co n f i r m yo u r ne w ba b y wa s in fac t en r o l l e d on yo u r poli c y . We ad v i s e yo u to ad d yo u r ba b y wit h i n th e firs t we e k aft e r bir t h . Do n ’ t wa i t .

8.

Eac h ins u r a n c e co m p a n y has dif f e r e n t rule s an d re g u l a t i o n s . Plea s e fa m i l i a r i z e yo u r s e l v e s wit h yo u r ins u r a n c e poli c i e s . For HM O ’ s , if ref e r r a l s to an o t h e r ph y s i c i a n ne e d to be m a d e , ple a s e be pa t i e n t . Mo s t ins u r a n c e co m p a n i e s re q u i r e th a t we co n t a c t th e m , an d ob t a i n pe r m i s s i o n (at ti m e s , up to tw o we e k s ) . It is yo u r res p o n s i b i l i t y to pic k u p th e ref e r r a l for m ( s ) an d m a k e ne c e s s a r y ap p o i n t m e n t s an d arr a n g e m e n t s . You m u s t ge t th e p h o n e nu m b e r of th e spe c i a l i s t fro m ou r Ref e r r a l de p a r t m e n t , call for an ap p o i n t m e n t an d th e n call ou r ref e r r a l de p a r t m e n t ba c k to m a k e th e ap p r o p r i a t e ref e r r a l . We will hel p yo u to m a k e th e ref e r r a l wh e n ne e d e d , bu t yo u m u s t hel p yo u r chil d ge t th e ap p r o p r i a t e ref e r r a l wh e n in d i c a t e d .

In ord e r for us to be m o s t effic i e n t du ri n g yo u r visi t , ple a s e : 1.

Ch e c k yo u r ins u r a n c e co v e r a g e to see wh e t h e r yo u r chil d r e n are co v e r e d un d e r yo u r pla n an d wh a t ser v i c e s th e y are en t i t l e d to.

2.

Fin d ou t yo u r res p o n s i b i l i t y wit h yo u r ins u r a n c e co m p a n y re g a r d i n g yo u r co- pa y m e n t an d / o r de d u c t i b l e are co n c e r n e d .

3.

Fin d ou t wh e t h e r yo u r ins u r a n c e co m p a n y will co v e r we ll- chil d car e , sick n e s s , hos p i t a l i z a t i o n , an d im m u n i z a t i o n s .

9.

Call for an ap p o i n t m e n t wh e n e v e r possi b l e . A sa m e da y visi t , suc h as for e m e r g e n c i e s will be acc o m m o d a t e d on a first co m e firs t ser v e basi s. We l l- chil d car e is onl y b y ap p o i n t m e n t .

If yo u ha v e a pro b l e m re a c h i n g a spe c i a l i s t ph y s i c i a n , ple a s e co n t a c t yo u r ins u r a n c e co m p a n y in ord e r for th e m to cla ri f y th e pro b l e m an d hel p yo u wit h yo u r ref e r r a l .

10.

If yo u ca n n o t pa y for th e visi t , ple a s e no t i f y us pri o r to yo u r visi t so th a t arra n g e m e n t s ca n be m a d e .

11.

Pay m e n t s ca n be m a d e by wa y of cas h , VISA, Mas t e r C a r d , Disc o v e r , AMEX or De b i t Car d . Pers o n a l ch e c k s will no t be acc e p t e d .

4.

5.

Ha v e yo u r ins u r a n c e car d av a i l a b l e up o n arri v i n g to th e offic e . Reg i s t e r yo u r chil d ’ s na m e at th e fro n t des k , an d spe c i f y if yo u r ins u r a n c e , ad d r e s s or ph o n e nu m b e r ha v e ch a n g e d . If yo u ha v e a dif f e r e n t na m e ot h e r th a n yo u r chil d r e n , ple a s e in d i c a t e so;


12.

If yo u r chil d wa s in th e e m e r g e n c y roo m or hos p i t a l i z e d , yo u m u s t m a k e a foll o w - up visit at on e of ou r offi c e s wit h i n 2 we e k s in ord e r for us to m o n i t o r yo u r chil d ’ s rec o v e r y . If yo u r chil d is ill, ple a s e co n t a c t us im m e d i a t e l y . We ha v e a 24 ho u r ser v i c e call ba c k , so no qu e s t i o n is to o s m a l l or to o big, wh e n in do u b t call. If issu e s wit h yo u r chil d occ u r in th e m o r n i n g , call us th e n , do no t hel p us by wa i t i n g un t i l 5 p m or lat e r to call, be c a u s e yo u did no t wa n t to bo t h e r us, yo u do no t bo t h e r us.

13.

If yo u ha v e an y qu e s t i o n s re g a r d i n g yo u r chil d ’ s car e , do no t hesi t a t e to co n t a c t us. Eit h e r a do c t o r , ARNP, RN or PA will res p o n d to yo u r call. If yo u do no t he a r fro m us, wit h i n an ho u r , ple a s e fe e l fre e to call ba c k .


GE T T I N G TO K N O W Y O U R BA B Y Con g r a t u l a t i o n s on yo u r ne w b o r n ba b y . You r ba b y is an in d i v i d u a l , fro m th e da y he or she is bo r n . As th e pa r e n t s , th e pe o p l e m o s t clos e l y in v o l v e d , yo u will co m e to kn o w yo u r ba b y th e bes t . Tru s t yo u r s e l f . Do n ’ t ta k e to o seri o u s l y all th e ad v i c e of we ll- m e a n i n g frie n d s an d rel a t i v e s . All ba b i e s sn e e z e , ya w n , belc h , ha v e hic c u p s , pass gas, co u g h , cry, an d ge t fuss y . Th e s e are no r m a l be h a v i o r s . Sne e z i n g is th e onl y wa y th a t ba b i e s ca n cle a n th e i r nos e s. Hicc u p s are just lit t l e m u s c l e sp a s m s , an d th e y ca n of t e n be sto p p e d by givi n g th e ba b y a fe w swa ll o w s of lu k e w a r m wa t e r . Cryi n g is a ba b y ’ s wa y of sa yi n g , “I a m we t , ” “I wa n t to be hel d , ” “I a m to o ho t , ” “I a m to o col d , ” “I’ m bo r e d , ” “I a m hu n g r y . ” ” You will gra d u a l l y lea r n to kn o w wh a t yo u r ba b y m e a n s wh e n he or sh e crie s. Bec a u s e yo u r up resis t a n c e du ri n g th e Disc o u r a g e ha n d l i n g th e ba b y ; ask th e m to

ba b y ha s no t ha d ti m e to buil d to inf e c t i o n , try to li m i t visit o r s firs t fe w we e k s at ho m e . frie n d s an d rela t i v e s fro m wa s h th e i r ha n d s first .

So m e t i m e s , ne w pa r e n t s are un s u r e of th e m s e l v e s . Bu t, as lon g as yo u r ba b y is lo v e d , we ll fe d, an d co m f o r t a b l e , yo u ne e d no t wo r r y th a t yo u are ine x p e r i e n c e d pa r e n t s .

GE N E R A L CA R E You r ba b y sho u l d ha v e re g u l a r m e d i c a l exa m i n a t i o n s , th o u g h he or she ap p e a r s we ll. Th e s e visit s will giv e us a ch a n c e to ch e c k on yo u r ba b y ’ s gro w t h an d de v e l o p m e n t an d to talk wit h yo u ab o u t ba b y car e . We will also giv e th e ba b y “s h o t s ” (va c c i n e s or im m u n i z a t i o n s ) to pro t e c t ag a i n s t chil d h o o d dise a s e s . An im m u n i z a t i o n sch e d u l e an d rec o r d ap p e a r at th e en d of this bo o k l e t . You r ba b y ’ s firs t m e d i c a l ch e c k u p sho u l d be be t w e e n 2 da y s an d 4 we e k s of ag e unl e s s, of co u r s e , th e do c t o r ’ s att e n t i o n is ne e d e d soo n e r . Plea s e call th e offic e for an ap p o i n t m e n t .

Att e m p t to m a k e we ll visi t ap p o i n t m e n t s on Tu e s d a y s , We d n e s d a y s or Th u r s d a y s . If it is an e m e r g e n c y , yo u m a y pro c e e d to bri n g th e chil d in th e offi c e (pr e f e r a b l y at 9: 0 0 a. m . or 2: 0 0 p. m . ). It will be co n si d e r e d a “ w a l k in ”. Prio r i t i e s will be asse s s e d wh e n th e chil d is tria g e d . Pho n e us du r i n g offic e ho u r s wh e n yo u fe e l yo u ne e d ad v i c e . We will be ha p p y to giv e yo u gui d a n c e an d ans w e r yo u r qu e s t i o n s . You will fin d it hel p f u l to ha v e pa p e r an d pe n c i l rea d y for wri t i n g do w n an y inst r u c t i o n s we m a y giv e . If an e m e r g e n c y occ u r s , call ou r off ic e im m e d i a t e l y . If yo u beli e v e th a t th e e m e r g e n c y is life th r e a t e n i n g in na t u r e , di a l 9 1 1 . Plea s e call us du ri n g offi c e ho u r s for m e d i c a t i o n ref ill s. An t i b i o t i c s CANN O T be refill e d . Dail y m e d i c i n e will no t be ref ill e d if yo u r chil d has no t be e n see n in ou r offic e wit h i n th e last 12 m o n t h s . Si g n s 1. 2. up ). 3. 4. 5. od o r ) . 6.

of Ill n e s s : Fev e r , wit h rec t a l te m p e r a t u r e of 10 1 º F or hig h e r . Ref u s a l of fee d i n g s or re p e a t e d vo m i t i n g (no t spit t i n g Exc e s s i v e cryi n g wit h o u t ob v i o u s ca u s e . List l e s s n e s s . Fre q u e n t flui d bo w e l m o v e m e n t s (w/ m u c u s , blo o d , or fo u l An y un u s u a l ras h (no t just pric k l y he a t ras h ).

SA F E T Y You wa n t to do ev e r y t h i n g po ssi b l e to assu r e a saf e en v i r o n m e n t for yo u r ba b y . Be g i n n i n g fro m th e firs t car tri p ho m e fro m th e hos p i t a l , yo u sho u l d al w a y s use an inf a n t car sea t wh e n e v e r yo u ta k e th e ba b y for rid e s. A ba b y ca n ge t seri o u s l y inj u r e d if su d d e n l y th e car sto p s wh i l e bei n g hel d in th e pass e n g e r ’ s ar m s ra t h e r th a n sec u r e d saf e l y in an inf a n t car sea t . We will be ha p p y to hel p yo u ch o o s e a go o d inf a n t car sea t . Th e car sea t sh o u l d be pro p e r l y fast e n e d faci n g ba c k w a r d s un t il 20l b s . Ch e c k th e sea t belt in th e car as we ll as th e bel t of th e car sea t bef o r e dri v i n g . To pro p e r l y stra p th e ba b y in th e car sea t , th e bel t s m u s t be sn u g tig h t , no t loo s e . This will avo i d th e ba b y to slip th r u th e bel t s in case of an e m e r g e n c y sto p . Follo w al w a y s th e m a n u f a c t u r e r ’ s


rec o m m e n d a t i o n s . Th e r e are m a n y si m p l e wa y s to ass u r e yo u r ba b y ’ s saf e t y at ho m e . For ex a m p l e , ne v e r lea v e th e ba b y alo n e on th e ta b l e or ot h e r hig h pla c e , wh e r e he or she co u l d roll off. Be sur e th e sla t s on th e crib an d pla y p e n are no m o r e th a n 2 3/ 8 inc h e s ap a r t , so th e ba b y ’ s he a d ca n n o t po ssi b l y ge t ca u g h t be t w e e n th e m . Th e m a t t r e s s sho u l d be fir m , fla t, an d fit th e crib sn u g l y on all fo u r sid e s. Ke e p th e crib fre e of clu t t e r . This m e a n s no pill o w an d no to y s in wh i c h th e ba b y co u l d be c o m e en t a n g l e d . Ba b i e s are att r a c t e d to col o r f u l an d shi n y obj e c t s . Kee p s m a l l obj e c t s like bu t t o n s an d pin s a w a y fro m th e ba b y ’ s re a c h so th a t he or she is no t te m p t e d to sw a l l o w th e m .


A ba b y ’ s deli c a t e skin ca n be bu r n e d easil y . W h e n yo u ta k e th e ba b y ou t s i d e , pro t e c t hi m or he r fro m th e ho t ra ys of th e su n. Al w a y s test th e wa t e r be f o r e yo u r ba b y ’ s ba t h to be sur e it is no t to o ho t. S m o k i n g cig a r e t t e s wh il e fee d i n g or pla y i n g wit h th e ba b y co u l d be da n g e r o u s be c a u s e ho t ash e s co u l d fall on th e ba b y . Also, do n ’ t hol d th e ba b y wh il e co o k i n g . Ho t fat co u l d spl a t t e r on th e ba b y , or he or she co u l d to u c h ho t pa n s or th e i r co n t e n t s . Ma k e sur e th a t yo u ne v e r lea v e yo u r chil d u n a t t e n d e d ne a r or in th e wa t e r wit h o u t su p e r v i s i o n .

R O O M TE M P E R A T U R E Try to ke e p an eve n , co m f o r t a b l e te m p e r a t u r e in yo u r ba b y ’ s roo m . Wi n d o w s m a y be op e n e d in wa r m we a t h e r , if th e ba b y is no t in a dra f t an d th e roo m te m p e r a t u r e do e s no t fall, bel o w 7 0 º - 7 6 º F.

co n t a c t wit h th e clo t h i n g . sock s onl y .

No ne e d

for sh o e s un t i l on e ye a r,

OUT D O O R S You ca n ta k e yo u r ba b y ou t si d e wh e n e v e r th e we a t h e r is ple a s a n t . Ba b i e s bo r n d u r i n g wa r m we a t h e r m a y be ta k e n ou t si d e aft e r th e y are ab o u t tw o we e k s old . If yo u use a car ri a g e or str o l l e r , be sur e th e wi n d blo w s ov e r th e to p an d no t int o it, dir e c t l y on yo u r ba b y . You sh o u l d avo i d ta ki n g yo u r ba b y to cro w d e d pla c e s in th e firs t tw o m o n t h s of life.

SOAP Use mi l d , un s c e n t e d soa p an d sh a m p o o .

CR I B Cov e r th e m a t t r e s s wit h a wa t e r p r o o f co v e r , quil t e d pa d , an d sof t ba b y she e t . Do no t use a pill o w . Cov e r th e ba b y wit h on e or t w o cot t o n bla n k e t s , be c a u s e this li m i t s fre e m o v e m e n t . No she e p skin bla n k e t .

SLE E P Th e posi t i o n to pla c e an inf a n t to sle e p has ch a n g e d thr o u g h o u t th e ye a r s. In 19 9 7 , th e AAP is rec o m m e n d i n g pla ci n g th e chil d on th e i r ba c k to sle e p . Pref e r a b l y wh il e a w a k e , ch e c k an d ch a n g e ba b y ’ s posi t i o n ev e r y t w o to th r e e ho u r s : exa m p l e , lef t sid e , th e n ba c k , an d th e n rig h t sid e . Ma k e sur e th e ba b y sle e p s at nig h t an d pla y at da y t i m e . Ma k e sur e th a t paj a m a s are no n fla m m a b l e m a t e r i a l .

CL O T H I N G A ba b y do e s no t re q u i r e an y m o r e clo t h i n g th a n th e ad u l t . Dre s s yo u r ba b y acc o r d i n g to th e te m p e r a t u r e . So m e ba b i e s are alle r g i c to cert a i n m a t e r i a l s , so wa t c h for ras h e s in are a s of

CA R E OF N A V E L Th e u m b i l i c a l cor d will fall off wit h i n a fe w we e k s . Eac h ti m e yo u ch a n g e yo u r ba b y ’ s dia p e r , use a cot t o n ball to ap p l y alc o h o l on th e na v e l . To cle a n th e u m b i l i c a l stu m p , pu ll th e stu m p up an d cle a n th e ba s e at lea s t on c e a da y or eve r y dia p e r ch a n g e . Ke e p i n g yo u r ba b y ’ s bell y dr y un t il th e cor d st u m p falls off is im p o r t a n t . Co n t a c t ou r offi c e if this ha p p e n s . So m e t i m e s , a fe w dro p s of blo o d m a y ap p e a r wh e n th e cor d falls off. This is no ca u s e for wo r r y .

CI R C U M C I S I O N If yo u r ba b y bo y wa s circ u m c i s e d , lea v e th e ga u z e aro u n d th e pe n i s un t i l it ha s be e n re m o v e d b y yo u r do c t o r , 24- 48 ho u r s af t e r th e pro c e d u r e (u n l e s s inst r u c t e d to, or falls off b y itse l f ) . If th e r e is an y ble e d i n g on th e incisi o n sit e th e n ap p l y a ga u z e an d sn u g pre s s u r e for 5 mi n u t e s . If ble e d i n g sto p s th e n co n t i n u e re g u l a r car e , if ble e d i n g pe rs i s t s th e n re a p p l y th e dry ga u z e wit h sn u g pre s s u r e an d co n t a c t ou r off ic e or th e ph y s i c i a n wh o ha s do n e th e circ u m c i s i o n . In th e eve n t yo u ca n n o t ge t hol d of


an y o n e go ba c k to th e E m e r g e n c y Roo m of th e ho s p i t a l th a t yo u r chil d wa s bo r n . Th e n ap p l y ne w ga u z e wit h Vase li n e or pol y s p o r i n (do u b l e an t i b i o t i c oin t m e n t ) on to p of th e pe n i s for 7 da y s . Rin s e dail y wit h un s c e n t e d soa p an d wa t e r . So m e t i m e s a yell o w exc r e t i o n is fo u n d in th e pe n i s . This is pa r t of th e he a li n g pro c e s s . Just ke e p wa s h i n g it ge n t l y wit h soa p an d wa t e r . In cas e of an y ble e d i n g or swe ll i n g or th e are a ha s a fo u l od o r , co n t a c t ou r offi c e .

BA T H I N G It is a go o d ide a Th e roo m sho u l d to g e t h e r to sa v e yo u r chil d . If th e chil d firs t .

to ha v e a re g u l a r ti m e for ba t h i n g yo u r ba b y . be wa r m , wit h no dra f t s . Kee p ba t h i n g su p p l i e s yo u ste p s. Alw a y s co n c e n t r a t e on ta ki n g car e of do o r b e l l or tel e p h o n e rin g s , ta k e car e of yo u r

Wa s h yo u r ba b y by sp o n g i n g un t il th e na v e l (a n d th e pe n i s , if circ u m c i s i o n wa s do n e ) is he a l e d . Th e n yo u ca n ba t h e th e ba b y in a sm a l l tu b co n t a i n i n g 3 inc h e s of co m f o r t a b l y wa r m wa t e r . Ch e c k th e te m p e r a t u r e of th e wa t e r b y test i n g it first wit h th e ski n of yo u r elb o w . Wa s h th e ba b y ’ s fac e wit h pla i n , wa r m wa t e r an d un s c e n t e d soa p . You m a y use a sof t clo t h , pre f e r a b l y use yo u r ha n d s . To cle a n aro u n d th e eye s, use cot t o n dip p e d in coo l wa t e r , wi p e th e eye s sh u t fro m th e ears to w a r d s th e nos e bri d g e . Do no t try to cle a n th e insi d e of eit h e r th e no s e or ears, b u t cle a n ou t e r are a s wit h a m o i s t wa s h c l o t h or cot t o n ball. Wa s h yo u r ba b y ’ s he a d wit h a mil d sha m p o o . Wo r k fro m fro n t to ba c k , to ke e p su d s a w a y fro m yo u r ba b y ’ s eye s . Cle a n car e f u l l y ove r th e sof t spo t s on a yo u n g ba b y ’ s he a d . If yo u no t i c e a gre a s y scali n g (cra d l e ca p ), call th e off ic e . Mo s t ba b i e s ge t cra d l e ca p in th e i r firs t six m o n t h s of life . It ap p e a r s an y t i m e , eve n wh e n yo u r ba b y ’ s ski n see m e d be a u t i f u l l y he a l t h y an d cle a r. Th e r e is no t m u c h to do to pre v e n t it. You m a y use mi n e r a l oil an d co m b th e hair dail y . First try a “n o te a r s ” sha m p o o . If it do e s no t im p r o v e , lets us kn o w .

Use a mil d soa p an d wa r m wa t e r to wa s h th e ba b y ’ s bo d y . Be sur e to wa s h th e fol d s of th e skin . Rin s e we ll. Pat th e ba b y dry. Do no t use po w d e r aft e r th e ba t h , be c a u s e th e ba b y co u l d in h a l e th e po w d e r an d ha v e tro u b l e bre a t h i n g . If th e skin is ve r y dry, yo u m a y use ba b y loti o n sp a ri n g l y aft e r th e ba t h . Tri m yo u r ba b y ’ s nails wit h a nail clip p e r . DO NOT cu t th e m wit h yo u r te e t h or rip th e m . You m a y use a file. Cu t th e ha n d ’ s nail circ u l a r an d th e to e n a i l s str a i g h t on to p of th e ski n . This m a y be ne c e s s a r y se v e r a l ti m e s a we e k .

Y O U R BA B Y ’ S SK I N In th e firs t se v e r a l da y s of life, yo u r ba b y ’ s skin m a y be pe e l i n g an d fla ki n g . Ski n cre a s e s like th e wris t , th e kn e e s , an d th e fe e t m a y cra c k an d ev e n ble e d . This pe e li n g is no r m a l . Use lot i o n spa r i n g l y if at all. Let th e skin he a l itse l f . If th e dry n e s s is se v e r e or th e pe e l i n g do e s no t su b s i d e , ple a s e ad v i s e th e p h y s i c i a n on yo u r ne x t visi t .

FEE D I N G TI M E Fee d i n g is on e of yo u r ba b y ’ s ple a s a n t ex p e r i e n c e s . At fee d i n g ti m e , th e ba b y rec e i v e s no u r i s h m e n t fro m th e foo d an d a fe e li n g of sec u r i t y fro m pa r e n t s ’ lo vi n g car e . Th e foo d hel p s yo u r ba b y to gro w he a l t h y an d str o n g . Pare n t a l lo v e sta r t s in th e de v e l o p m e n t of a sec u r e an d sta b l e pe r s o n a l i t y . Bot h yo u an d th e ba b y sho u l d be co m f o r t a b l e at fe e d i n g ti m e . Ch o o s e a posi t i o n th a t will hel p yo u rela x as yo u fee d yo u r ba b y . For yo u r ba b y ’ s co m f o r t , be sur e he or sh e ha s a dry dia p e r .

A SC H E D U L E W I T H FLE X I B I L I T Y A fee d i n g sch e d u l e is usu a l l y m o s t sat isf a c t o r y if it is fle x i b l e , allo w i n g th e ba b y to ea t wh e n he or sh e be c o m e s hu n g r y . Ver y yo u n g ba b i e s usu a l l y wa n t to be fe d ev e r y t w o to 4 ho u r s , bu t old e r ba b i e s m a y wa i t up to fiv e ho u r s be t w e e n fe e d i n g s . Alt h o u g h cryi n g is th e onl y wa y a ba b y ca n co m p l a i n of hu n g e r , cryi n g m a y m e a n ot h e r thi n g s as we ll. If yo u r ba b y occ a s i o n a l l y


crie s wit h i n tw o ho u r s af t e r fee d i n g , hu n g e r pro b a b l y is no t th e pro b l e m .

TY P E O F FEE D I N G Bre a s t mi l k is th e bes t fe e d i n g for a ba b y . If yo u do no t ch o o s e to bre a s t fe e d , we rec o m m e n d an inf a n t for m u l a , pro b a b l y on e for t i f i e d wit h iro n . Bre a s t mi l k or an inf a n t for m u l a is th e onl y fo o d yo u r ba b y ne e d s in th e first fo u r to six m o n t h s of life . Bre a s t mi l k , inf a n t for m u l a , or ot h e r nu t r i t i o n a l be v e r a g e s spe c i f i c a l l y desi g n e d for old e r inf a n t s sho u l d be co n t i n u e d un t il yo u r ba b y ’ s fi r s t bi r t h d a y . Th e co w ’ s mil k th a t th e rest of th e fa m i l y dri n k s is no t an ap p r o p r i a t e fee d i n g for a chil d less th a n on e ye a r old.

FEE D I N G P O S I T I O N W h e t h e r bre a s t - fee d i n g or bo t t l e - fee d i n g , hol d yo u r ba b y clo s e . Th e ba b y ’ s he a d sh o u l d be slig h t l y rais e d an d rest e d in th e be n d of yo u r elb o w .

TE C H N I Q U E O F BRE A S T FEE D I N G Bef o r e fee d i n g yo u r ba b y , rin s e yo u r bre a s t wit h pla i n wa t e r , an d pa t th e m dr y. You m a y ne e d to hel p a ne w b o r n ba b y sta r t nu rs i n g . Do no t pu s h th e ba b y to w a r d th e bre a s t . Inst e a d , as yo u hol d th e ba b y , ge n t l y stro k e th e ch e e k ne a r e r th e bre a s t . Th e ba b y will res p o n d by tu r n i n g his or he r he a d to th e bre a s t see k i n g th e nip p l e . Th e nip p l e an d th e da r k are a aro u n d it (th e are o l a ) sh o u l d be in th e ba b y ’ s m o u t h . Press u r e of th e ba b y ’ s m o u t h on th e are o l a rel e a s e s mil k fro m yo u r bre a s t . You m a y ne e d to pla c e a fin g e r or t w o on yo u r bre a s t to ke e p it a w a y fro m yo u r ba b y ’ s no s e . Ot h e r w i s e , th e ba b y m a y ha v e tro u b l e bre a t h i n g . Use bo t h bre a s t s du ri n g ea c h fe e d i n g . Wh e n yo u firs t be g i n to nu rs e , pu t th e ba b y to ea c h bre a s t for ab o u t fiv e mi n u t e s . Gra d u a l l y b uil d up to 1 5 to 20 mi n u t e s at th e first bre a s t .

Con t i n u e at th e sec o n d bre a s t un t i l yo u r ba b y is sat isf i e d . Ma n y ba b i e s will suc k for a lon g ti m e , m a y b e lo n g e r th a n 15 mi n u t e s . Prolo n g e d nu r s i n g ca n be ex h a u s t i n g for yo u an d yo u r ba b y . Be g i n ea c h fee d i n g at th e bre a s t yo u fin is h e d wit h th e pre v i o u s ti m e , esp e c i a l l y if th e ba b y did no t fee d lon g on th a t bre a s t . We su g g e s t yo u to un s n a p on e clas p on yo u r nu r s i n g bra fla p to re m i n d yo u r s e l f wh i c h bre a s t to be g i n wit h at th e ne x t fe e d i n g . Bre a s t - fee d i n g m o m s m u s t dri n k up to fiv e to se v e n gla ss e s of flu i d s a da y an d m a y ea t eve r y t h i n g th a t th e y pre f e r to ea t no t exc e s s i v e l y , un l e s s sp e c i f i e d by a pro f e s s i o n a l . If yo u r bre a s t hu r t , try ap p l y i n g ca b b a g e (co l d ) on to th e bre a s t . Also use of ice pa c k s on c e in a wh i l e hel p s relie v e th e pai n to o . If yo u ne e d to se p a r a t e yo u r s e l f fro m th e ba b y at fee d i n g ti m e , yo u ca n lea v e eit h e r a bo t t l e of mi l k th a t yo u “e x p r e s s e d ” (sq u e e z e d ) fro m yo u r bre a s t or a bo t t l e of pre p a r e d inf a n t for m u l a . If yo u use su p p l e m e n t a l for m u l a , we rec o m m e n d th e on e ch e c k e d bel o w : S U G G E S T E D SU P P L E M E N T A R Y FE E D I N G (se e For m u l a Pre p a r a t i o n inst r u c t i o n bel o w )

 Enf a m i l  Enfa m i l Fre e  Co n c e n t r a t e d Liq u i d , ___1__oz, plu s __1___ oz of wa t e r  Pow d e r ___1__ le v e l sco o p s , plu s __2___ oz of wa t e r  Rea d y To Fee d , do no t dil u t e .  Enf a m i l Lipil wit h Iro n

Lact o s e

FO R M U L A PR E P A R A T I O N A si m p l e wa y to pre p a r e for m u l a is to mi x it an d po u r it int o cle a n nu r s i n g bo t t l e s , an d th e n to ke e p th e for m u l a ste r il e in th e bo t t l e . You sh o u l d pre p a r e yo u r ba b y ’ s for m u l a this wa y un t i l we tell yo u ot h e r w i s e . You will ne e d th e follo w i n g thi n g s to pre p a r e for m u l a : - Ste ril i z e r or de e p po t wit h rac k * - Dis h w a s h e r ( m a y b e use d to ste ri li z e bo t t l e s to o ) - Can op e n e r - Bot t l e br u s h - Nur si n g bo t t l e s , nip p l e s , an d ca p s


-

Qu a r t m e a s u r i n g pit c h e r To n g s Lo n g - ha n d l e d spo o n For m u l a

All, ite m s use d in pre p a r i n g yo u r ba b y ’ s for m u l a m u s t be cle a n . Scr u b bo t t l e , nip p l e s , an d ca p s wit h ho t wa t e r an d de t e r g e n t , usi n g a bo t t l e bru s h . Sq u e e z e wa t e r thr o u g h th e nip p l e hol e s. Th e m e a s u r i n g pit c h e r , ca n op e n e r , an d ot h e r arti c l e s also sho u l d be wa s h e d we ll. Rins e ev e r y t h i n g th o r o u g h l y wit h ho t wa t e r . Just bef o r e yo u mi x th e for m u l a , wa s h yo u r ha n d s we ll. Th e n wa s h th e to p of th e for m u l a ca n wit h soa p , rin s e it, an d dr y it bef o r e op e n i n g . Be sur e yo u ch e c k th e ex p i r a t i o n da t e on th e ca n ; do no t use th e for m u l a af t e r th a t da t e . M i x i n g Fo r m u l a a n d Pr e p a r i n g Bo t t l e s of Co n c e n t r a t e d Li q u i d or P o w d e r Fo r m u l a (Al w a y s rea d th e inst r u c t i o n s on th e con t a i n e r )

1. 2. 3.

4. 5.

Fill a qu a r t - size pit c h e r wit h _____ ou n c e s (oz.) of wa t e r . Ad d _____ sco o p s of po w d e r for m u l a * or _____ on c e (oz.) of co n c e n t r a t e d liq u i d for m u l a . Stir we ll wit h a lon g ha n d l e d spo o n . Pou r th e mi x e d for m u l a int o _____ cle a n nu rs i n g bo t t l e s . Divi d e th e for m u l a eq u a l l y a m o n g th e bo t t l e s , so th a t ea c h bo t t l e co n t a i n s at lea s t _____ ou n c e s (oz.). This is th e a m o u n t th a t we pre s c r i b e for a sin g l e fe e d i n g . Put nip p l e s up si d e - do w n on th e bo t t l e s . Put on ca p s, lea v i n g th e m loo s e so th a t ste a m ca n ge t un d e r th e m . Ste ril i z e b y th e m e t h o d bel o w .

STE R I L I Z A T I O N 1.

3.

Sta n d bo t t l e s of for m u l a on a wir e rac k or cle a n , fol d e d to w e l in a ste r il i z e r or po t . Ca p s sh o u l d be loo s e , no t scre w e d tig h t l y . Put ab o u t 3 inc h e s of wa t e r in th e ste r il i z e r or po t. Bri n g wa t e r to a boil ov e r m o d e r a t e he a t . Cov e r th e po t , an d boil ge n t l y for 25 mi n u t e s (Ca u t i o n : do no t use a mi c r o w a v e ove n ) . Re m o v e th e po t fro m th e he a t . Do no t lift th e lid un t i l th e

4. 5. 6. 7.

po t has coo l e d en o u g h for yo u to to u c h it. This us u a l l y ta k e s ab o u t an ho u r . Re m o v e th e coo l e d bo t t l e s , an d tig h t e n th e ca p s. Sto r e th e bo t t l e s of for m u l a in th e ref r i g e r a t o r . Use th e pre p a r e d for m u l a wit h i n 48 ho u r s . Do no t lea v e mi l k in ca n s. Use pla s t i c co n t a i n e r s . Thr o w aw a y an y for m u l a lef t aft e r this ti m e . You m a y also use th e dis h w a s h e r to ste ri li z e th e bo t t l e s , as th e ho t wa t e r cle a n s th e bo t t l e s an d nip p l e s we ll.

* N o t e s : If you do not hav e a ste r i l i z e r , a ket t l e or pot wit h lid will be sat i sf a c t o r y . It m u s t be dee p eno u g h so th e bot t l e s do not to u c h the lid. An d th e bo t t l e s m u s t not bot t o m . If you do not hav e a rac k th a t fit s th e po t , a cle a n , will do.

a well fit t i n g top s of th e rest on the fold e d to w e l

RE A D Y TO FEE D FO R M U L A N e v e r a d d w a t e r to re a d y - to- fe e d for m u l a , an d do no t st e r i l i z e this kin d of for m u l a . Just po u r ____ ou n c e s (oz.) of rea d y - to- fe e d for m u l a in t o a cle a n ste ri li z e d nu rs i n g bo t t l e , an d giv e it to yo u r ba b y . Op e n ca n s of re a d y - to- fe e d for m u l a sh o u l d be co v e r e d an d sto r e d in th e ref ri g e r a t o r . Thr o w ou t an y lef t af t e r 4 8 ho u r s .

TO W A R M FO R M U L A If yo u r ba b y pre f e r s wa r m for m u l a , re m o v e a bo t t l e fro m th e ref r i g e r a t o r just bef o r e fe e d i n g an d pu t it in a po t of ho t (n o t boili n g ) wa t e r for a fe w mi n u t e s . Or use a bo t t l e wa r m e r . Do no t use a mi c r o w a v e ove n , be c a u s e th e for m u l a m a y be c o m e scal d i n g ho t wh i l e th e bo t t l e re m a i n s coo l to th e to u c h . You do no t ha v e to wa r m th e for m u l a wit h eve r y fe e d i n g , te a c h yo u r chil d to dri n k col d mi l k to o, is ref r e s h i n g an d sat isf a c t o r y . Bef o r e fee d i n g th e ba b y , tes t th e te m p e r a t u r e of th e for m u l a by sha k i n g a fe w dro p s on th e insi d e of yo u r wris t . It sho u l d fe e l wa r m , bu t no t ho t .

TE C H N I Q U E FO R BO T T L E FEE D I N G Hol d th e bo t t l e so th a t th e ne c k of th e bo t t l e an d th e nip p l e are alw a y s fille d wit h for m u l a . This hel p s yo u r ba b y rec e i v e for m u l a


inst e a d of air. Air in th e ba b y ’ s sto m a c h m a y giv e a fals e se n s e of bei n g full an d m a y ca u s e disc o m f o r t .

sho u l d dri p s m o o t h l y , wit h o u t for m i n g a stre a m .

Suc ki n g is pa r t of th e ba b y ’ s ple a s u r e at fee d i n g ti m e . A ba b y m a y co n t i n u e to suc k on a nip p l e eve n aft e r it ha s colla p s e d . So ta k e th e nip p l e ou t of yo u r ba b y ’ s m o u t h occ a s i o n a l l y to be sur e it has no t coll a p s e d . N e v e r pro p a bo t t l e an d lea v e yo u r ba b y alo n e to fe e d . Th e bo t t l e co u l d slip an d m a k e th e ba b y ga g . Also , dri n k i n g fro m a pro p p e d bo t t l e m a y be rela t e d to to o t h de c a y (ca v i t i e s ) in old e r inf a n t s . Re m e m b e r , to o, yo u r ba b y ne e d s th e sec u r i t y an d ple a s u r e of bei n g hel d at fe e d i n g ti m e . Face to fac e co n t a c t is ve r y im p o r t a n t for yo u r ba b y . Ne v e r lea v e a ba b y sle e p i n g wit h a bo t t l e in th e i r m o u t h , it wo u l d ca u s e to o t h de c a y of th e fro n t a l te e t h .

BU R P I N G

Mos t ba b i e s fee d for 15 to 20 mi n u t e s . So m e t i m e s th e ba b y will ta k e all th e for m u l a in th e bo t t l e an d so m e t i m e s no t . Do n ’ t wo r r y ; this is no r m a l . You sho u l d ne v e r forc e yo u r ba b y to ea t or to finis h eve r y bo t t l e . Thr o w ou t an y for m u l a lef t in th e bo t t l e . W h e n yo u r ba b y re g u l a r l y fin is h e s th e en t i r e bo t t l e at eac h fe e d i n g - an d so m e t i m e s cry for m o r e - it m a y be ti m e to incr e a s e th e a m o u n t of for m u l a . You r ba b y will ne e d lar g e r a m o u n t of for m u l a as he or she gro w s . W h e n th e ba b y is bo r n th e ba b y m a y dri n k ab o u t 2 oz at eac h fe e d i n g . You sho u l d try to incr e a s e by half an ou n c e eve r y bo t t l e ev e r y fiv e da y s . W h e n th e bo t t l e is e m p t y yo u m a y wa n t to incr e a s e ab o u t ¼ to ½ an oz pe r fee d i n g up to a m a x i m u m of 8 oz pe r fee d i n g an d ab o u t 20 – 28 oz pe r da y . DO NOT FEED WHILE BABY IS SLEEPING AND DO NOT SLIP A BOTTLE TO THEIR MO UT H WHIL E SLEEPING EITHER. IT IS BA D PRACTICE AND MAY CAUSE YOUR CHIL D TO BE OBESE. Aft e r fe e d i n g ti m e , rin s e th e bo t t l e wit h co o l wa t e r an d sq u e e z e wa t e r th r o u g h th e nip p l e hol e . Alt h o u g h yo u will wa s h th e eq u i p m e n t th o r o u g h l y lat e r, nip p l e hol e s m a y be clo g g e d if th e y are no t rin s e d rig h t af t e r use . Test nip p l e s re g u l a r l y to be sur e th e hol e s are th e rig h t size. Do no t m a k e an y hol e s in th e nip p l e s . Bu y ne w nip p l e s . If th e nip p l e hol e s are to o sm a l l , th e ba b y m a y tire of suc k i n g be f o r e ge t t i n g all th e for m u l a he or she ne e d s . If th e hol e s are to o lar g e , th e ba b y will ge t to o m u c h for m u l a to o fast . Th e ba b y m a y also ge t so m u c h air th a t he or she spit s up all or pa r t of th e fee d i n g . W h e n th e nip p l e hol e s are th e rig h t size, wa r m inf a n t for m u l a

Bu r p i n g yo u r ba b y hel p s re m o v e sw a l l o w e d air. To bu r p yo u r ba b y , hol d hi m or he r up ri g h t ov e r yo u r sh o u l d e r , an d ge n t l y pa t or ru b th e ba c k . An o t h e r wa y is to pla c e th e ba b y fac e do w n acr o s s yo u r lap an d ge n t l y ru b th e ba c k . Or yo u ca n sit th e ba b y on yo u r la p, lea n i n g slig h t l y for w a r d , wit h yo u r ha n d su p p o r t i n g th e ch e s t . Bu r p th e ba b y se v e r a l ti m e s du r i n g , as we ll as af t e r , ea c h fee d i n g . So m e t i m e s , th e ba b y will no t be abl e to bu r p . Do no t try to forc e th e ba b y to bu r p if th e firs t fe w att e m p t s are no t succ e s s f u l . Do no t be ala r m e d if yo u r ba b y spit s up a fe w dro p s wh e n bei n g bu r p e d .

O T H E R FEE D I N G Esp e c i a l l y in ho t we a t h e r an d bo u t s of dia r r h e a , yo u m a y off e r yo u r ba b y luk e w a r m , boil e d wa t e r (co o l e d off) in a nu r si n g bo t t l e on c e or twi c e a da y. Do n ’ t giv e yo u r ba b y so m u c h wa t e r th a t he or sh e be c o m e s full an d un i n t e r e s t e d of th e bre a s t mi l k or for m u l a . Do no t giv e yo u r ba b y su g a r y liq u i d s , like sof t dri n k s or juic e s, to dri n k fro m th e bo t t l e . Th e y ca n ha r m yo u r ba b y ’ s te e t h or ca u s e dia r r h e a . Re g u l a r mil k , ev e n if boil e d , also is no t as go o d as bre a s t mi l k or inf a n t for m u l a for a ba b y in th e first ye a r of life. Reg u l a r mi l k in th e first ye a r has ca u s e d blo o d y sto o l s an d lo w blo o d co u n t s . You sh o u l d wa i t to giv e soli d fo o d s to th e ba b y un t i l he or she is 2 to 6 m o n t h s old . W h e n th a t ti m e is ne a r, we will disc u s s wit h yo u th e ad d i t i o n of ne w foo d s to th e ba b y ’ s die t . N o t e : Use the scoo p wit h the for m u l a . Do not use any kin d of spoo n or m e a s u r e . Pow d e r is also av ail a b l e in pac k e t s . If you bu y pac k e t s or po w d e r for m u l a , al w a y s follo w the pr e p a r a t i o n inst r u c t i o n s car e f u l l y .

VITA M I N S W h e n yo u r ba b y is _____ we e k s old, be g i n givi n g th e vit a m i n th e Pedi a t r i c i a n ch e c k s bel o w . P r e s c r i p t i o n Vi t a m i n s Vi t a m i n s  Poly- Vi- Sol ® dro p s

O v e r - th e - co u n t e r

 Poly- Vi- Sol ® w/ iro n dro p s


 Tri- Vi- Sol ® dro p s  Poly- Vi- Flor ® dro p s

 Tri- Vi- Sol ® w/ iro n dro p s  Poly- Vi- Flor ® dro p s

Dos a g e :  1/ 2 cc  1 cc dro p p e r dail y . To giv e vit a m i n s , pla c e th e dro p p e r be t w e e n th e ba b y ’ s gu m an d ch e e k , al m o s t half w a y ba c k in th e m o u t h . Slo w l y sq u e e z e ou t co n t e n t s of th e dro p p e r .

ST O O L S Sto o l s of ne w b o r n ba b i e s va r y co n s i d e r a b l y in size, col o r, co n si s t e n c y , an d fre q u e n c y . Bo w e l m o v e m e n t s m a y be eve r y fe e d or on c e a da y or ev e r y ot h e r da y . A ba b y m a y ha v e on e or se v e r a l bo w e l m o v e m e n t s dail y , or no n e for a fe w da y s. Sto o l s m a y be yell o w , bro w n , or gre e n , an d m a y b e fir m , loo s e , or pas t y . Sof t, loo s e , pas t y sto o l s are ty p i c a l for bre a s t - fe d inf a n t s If th e r e is no bo w e l m o v e m e n t in tw o to fiv e da y s , ple a s e call. Ch a n g e yo u r ba b y ’ s dia p e r as soo n as po ssi b l e aft e r eac h bo w e l m o v e m e n t . Cle a n th e dia p e r are a an d wi p e it ge n t l y , pre f e r a b l y wit h a co t t o n ball m o i s t e n e d wit h wa t e r . You m a y use wi p e s wh e n no t at ho m e . On e of th e m o s t co m m o n illn e s s e s a m o n g inf a n t s an d yo u n g chil d r e n is dia r r h e a . Dia r r h e a is co n si d e r e d an incr e a s e d fre q u e n c y of bo w e l m o v e m e n t fro m th e usu a l. Usu a l l y , dia r r h e a last s onl y for a fe w da y s an d ca n be m a n a g e d at ho m e . Du r i n g bo u t s of dia r r h e a , re g u l a r fee d i n g s , esp e c i a l l y mil k sh o u l d so m e t i m e s be re p l a c e d wit h spe c i a l flui d s co n t a i n i n g im p o r t a n t nu t r i e n t s (ele c t r o l y t e s ) in a m o u n t s si m i l a r to th o s e lost in sto o l s. We su g g e s t yo u bu y a fe w bo t t l e s of Pedi a l y t e * so yo u ha v e th e m on ha n d if yo u ne e d th e m . Plea s e call ou r off ic e for inst r u c t i o n s if yo u r ba b y ha s dia r r h e a for m o r e th a n a da y, esp e c i a l l y if acc o m p a n i e d by vo m i t i n g or fe v e r or if th e chil d do e s n ’ t loo k we ll at an y ti m e .

CO N C L U S I O N This is a joy o u s ti m e in yo u r liv e s. You ha v e a ba b y pro d u c t of yo u r lo v e th a t ha s co m e to co m p l i m e n t yo u r ho u s e h o l d an d m a k e of yo u a fa m i l y . Ma k e de ci si o n s to g e t h e r , rat h e r ag a i n s t ea c h ot h e r . Ru b Pedi a t r i c s an d sta f f co n g r a t u l a t e yo u an d yo u r ne w bu n d l e of jo y.

OFFICE HO U R S Mo n d a y thr o u g h Frid a y : 8: 3 0 a m - 5: 0 0 p m . Ple a s e call for an ap p o i n t m e n t . Sat u r d a y s : 8: 3 0 a m - 12: 0 0 no o n at ou r Ave n t u r a Offic e (sic k visit s onl y ) . We pro v i d e 24 ho u r Pedi a t r i c ser v i c e . Aft e r ho u r s we ca n be rea c h e d by calli n g ou r offic e tel e p h o n e nu m b e r s : (3 0 5 ) 69 6 94 9 0 or (3 0 5 ) 93 2 - 10 0 7 . You r call will be ta k e n b y an an s w e r i n g ser v i c e th a t will tra n s f e r yo u to a nu r s e th a t will tria g e yo u r call an d disc u s s yo u r chil d ’ s m e d i c a l pro b l e m . If ne c e s s a r y , th e y will co n t a c t th e ph y s i c i a n on call. E NJ O Y YO U R BA B Y !


NAME:

DOB: P N E U M O C O C C A L (P P V ) : 1 D O S E NAME:

I M M U N I Z A T I O N RE C O R D Im m u n i z a ti o n

Da t e Loc a t i o n Gi v e n Ad m i n i s t e r e d PE D I A R I X ( D T a P , IP V , HE P B): 3 D O S E S

I N F L U E N Z A (F L U ) : 1 D O S E (G I V E N SE P T TO JAN ) 6 TO 35 MONT HS ( ½ DOSE) 3 YEARS + (.5M L)

2 MONT HS 4 MONT HS 6 MONT HS

HE P A T I T I S A ( H E P A) : 2 D O S E S 6 M O N T H S AP A R T 2 YEARS + 2 YEARS +

HE P A T I T I S B: 3 D O S E S

TU B E R C U L O S I S (P P D ) : HI G H RI S K AF T E R 1 YE A R )

1 MONT H 3 MONT HS 9 MONT HS

PPD PPD PPD PPD PPD PPD PPD PPD

DI P H T H E R I A , TE T A N U S , PE R T U S I S ( D T a P ) : 5 D O S E S 2 MONT HS 4 MONT HS 6 MONT HS 18 MONT H S 4 YEARS 2 MONT HS 4 MONT HS 18 MONT H S 4 YEARS

HAE M O P H I L U S INFL U E N Z A E

TY P E B ( H I B ) : 4 D O S E S

2 MONT HS 4 MONT HS 6 MONT HS 15 MONT H S

PNEU M O C O C C A L DOS E S

CO NJ U G A T E

VACCI N E

(P R E V N A R ) :

4

3 MONT HS 5 MONT HS 7 MONT HS > 1 2 MONT H S

CH I C K E N P O X ( V A R I C E L L A ) : 1 D O S E 12 MONT H S > 4 YEARS

M E A S L E S , M U M P S , RU B E L L A ( M M R ) : 2 D O S E S 15 MONT H S 4 YEARS

TE T A N U S

TO X O I D

( D t ) : 1 D O S E (U N D E R

7

UNDE R 7 YEARS

TE T A N U S DI P H T H E R I A TO X O I D D O S E (E V E R Y 1 0 YRS AF T E R 1 2 YRS ) 12 YEARS +

RESULTS: RESULTS: RESULTS: RESULTS: RESULTS: RESULTS: RESULTS: RESULTS:

SY N A G I S : HI G H RI S H RS V GI V E N M O N T H L Y F O R 2 YE A R S

P O L I O (I P V ) : 4 D O S E S

DI P H T H E R I A YR S )

DOB:

> 2 4 MONT H S

A N D PE R T U S S I S

(T D ) : 1

SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS SYNA GIS

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

OT H E R : OT H E R : OT H E R : OT H E R :


SA M P L E V I S I T I N G SC H E D U L E VI S I T 0- 4 we e k s 1 mont h 2 mont hs (ch e c k u p )

3 4 5 6

mont hs mont hs mont hs mont hs

(ch e c k u p / l a b s )

8/ 9 m o n t h s 12 m o n t h s 15 m o n t h s 18 m o n t h s 24 m o n t h s (ch e c k u p / v a c c i n e s)

30 m o n t h s 36 m o n t h s 40 m o n t h s (e y e / h e a r i n g / l a b s )

48 m o n t h s (ch e c k u p / v a c c i n e s)

5 yea r s (ch e c k u p ye a r l y )

6 yea r s 7 yea r s 8 yea r s 9 yea r s 10 yea r s 11 yea r s 12 yea r s 13 yea r s 14 yea r s 15 yea r s 16 yea r s 17 yea r s 18 yea r s

HT

WT

HC

Ques ti o n s

RA I S I N G CH I L D R E N Raisi n g chil d r e n is no t as dif f i c u l t as pe o p l e m a y thi n k . We all wa n t to be pe rf e c t pa r e n t s an d we all wa n t to ha v e th e s m a r t e s t an d m o s t be a u t i f u l chil d . In ord e r to ans w e r so m e of th e qu e s t i o n s yo u m a y ha v e ab o u t ta ki n g car e of yo u r chil d , we wo u l d like to sha r e a fe w poi n t e r s wit h yo u th a t we ha v e lea r n e d fro m pra c t i c i n g m e d i c i n e an d de a li n g wit h chil d r e n for m a n y ye a r s . Th e follo w i n g are 12 eas y thi n g s to re m e m b e r : 1. 2. 3. 4. 5. 6.

It is im p o r t a n t for us, th e do c t o r s , to wo r k to g e t h e r wit h yo u , th e pa r e n t s . Chil d r e n are incli n e d to be go o d - na t u r e d , bu t soci e t y ca n spo il th e m . Just as we co n si d e r th e fac t th a t all chil d r e n are alik e , we ca n also sa y th a t all chil d r e n are uni q u e . If yo u are usi n g for m u l a s , fee d yo u r chil d eve r y 4 ho u r s a da y. You ca n off e r yo u r ba b y wa t e r , 1 ho u r af t e r fee d i n g s , 3 ti m e s pe r da y . Chil d sh o u l d be ta u g h t to be a w a k e du r i n g th e da y an d sle e p at nig h t . W h e n sp e a k i n g ab o u t bre a s t fee d i n g , th e ba b y sh o u l d be fe d as m u c h as he/ s h e wa n t s to ea t , no t as of t e n as he/ s h e wa n t s to ea t. Try to bre a s t fee d yo u r chil d ev e r y thr e e ho u r s du ri n g th e da y, th e first m o n t h , an d eve r y fo u r ho u r s , th e ne x t se v e r a l m o n t h s . Ha v e a po si t i v e at t i t u d e : Th e gla ss is half full; no t half

7. empty. 8. Ho w m u c h do e s a chil d ea t? As m u c h as th e chil d wa n t s . Th e chil d kn o w s his/ h e r ne e d s be t t e r th a n an y b o d y else. 9. Try to ke e p fro m telli n g yo u r chil d wh a t no t to do. It wo u l d be easi e r an d m o r e eff e c t i v e to tell hi m / h e r wh a t he/ s h e ca n or sh o u l d do. You r chil d will be m o r e coo p e r a t i v e . 10. Chil d r e n are pro n e to ge t t i n g inf e c t i o u s dis e a s e s m o r e of t e n th a n ad u l t s . This is no r m a l un t i l th e y buil d de f e n s e s


11. 12. 13.

to co m b a t th e m . Onl y ba c t e r i a l inf e c t i o n s ne e d an t i b i o t i c s . Vira l inf e c t i o n s are m o r e co m m o n . A col d m a y last for t w o we e k s , wh il e alle r g i c sy m p t o m s m a y re m a i n fro m 4 to 5 we e k s . Chil d r e n are no t “h y p e r a c t i v e ” , th e y are just full of en e r g y . We ca n ge t tir e d wa t c h i n g th e nu m b e r of act i v i t i e s th e y do all da y. Chil d r e n do no t “b r e a k ” to y s. Th e y are si m p l y curi o u s to see wh a t is insi d e th e m . Foc u s on yo u r chil d ’ s de v e l o p m e n t an d ale r t us wh e n th e r e are issu e s . Mos t of th e ti m e th e r e are no r m a l issu e s , bu t ea rl y int e r v e n t i o n m a y be th e ke y to hel p yo u r chil d op t i m i z e th e i r bes t .

DI E T SC H E D U L E 6: 0 0 a m Lac t o f r e e 7: 0 0 a m 10: 0 0 a m 11: 0 0 a m 2: 0 0 p m Lac t o f r e e 3: 0 0 p m 6: 0 0 p m Lac t o f r e e

SI N G L E GR A I N BA B Y CE R E A L PORTIONS

1 st da y : a ta b l e s p o o n plu s m o t h e r ’ s mi l k , for m u l a or wa t e r . 2 nd da y : t w o ta b l e s p o o n s plu s m o t h e r ’ s mil k , for m u l a or wa t e r . 3 rd da y : thr e e ta b l e s p o o n s plu s m o t h e r ’ s mi l k , for m u l a or wa t e r . Th e r e a f t e r : fo u r ta b l e s p o o n s pe r ser v i n g Rice Cer e a l , Barl e y Cer e a l , Oat m e a l FI R S T FO O D S FR U I T S 2.5 oz. Jar Port i o n s 1 st da y : 1/ 2 jar 2 nd da y : 1/ 2 jar 3r d da y : 1/ 2 jar Th e r e a f t e r : 1 Jar Ap p l e s a u c e co n t a i n e r .  Pears  Peac h e s  Ba n a n a s  Pru n e s

0 - 2 MO N T H S Bre a s t

Mil k

or

Enf a m i l

LIPIL,

or

Proso b e e ,

W ATER Bre a s t Mil k or Enf a m i l LIPIL, or Proso b e e , Lact o f r e e W ATER Bre a s t Mil k or Enf a m i l LIPIL, or Proso b e e , W ATER Bre a s t Mil k

or

Enf a m i l

LIPIL,

or

Port i o n s 1 st da y : 1 fl. oz. 2 nd da y : 1 1/ 2 fl. oz. 3 rd da y : 1 3/ 4 fl. oz. Th e r e a f t e r : At leas t 2 fl. oz.  bu t m o s t ba b i e s enj o y a full  Ap p l e Juice  Wh i t e Gra p e Juice  Pear Juice

FI R S T FO O D S V E G E T A B L E S

Proso b e e ,

2.5O Z JAR PORTIONS

Bat h e you r chil d 10: 0 0 p m Bre a s t Mil k or Enf a m i l LIPIL, or Proso b e e , Lact o f r e e Aft e r 10: 0 0 p m W a t e r Onl y or Bre a s t Mil k ( m a y off e r du r i n g the nig h t ) .

1 st da y : 2 nd da y : 3 rd da y :

DI E T SC H E D U L E 2 - 5 M O N T H S 6: 0 0 a m Cer e a l , Br e a s t Mil k or Enf a m i l LIPIL,or Proso b e e , Lac t o f r e e 7: 0 0 a m W ATER 10: 0 0 a m Frui t /Juic e , Br e a s t Mil k or Enf a m i l LIPIL, or Pros o b e e , Lac t o f r e e 11: 0 0 a m W ATER 2: 0 0 p m Veg e t a b l e , Bre a s t Milk or Enf a m i l LIPIL, or Proso b e e , Lac t o f r e e 3: 0 0 p m W ATER 6: 0 0 p m Cer e a l (Bat h ) , Bre a s t Milk or Enf a m i l LIPIL, Proso b e e , Lac t o f r e e 10: 0 0 p m Mil k Aft e r 10: 0 0 p m W ATER ONLY.

I N F A N T JUICE S

1/ 2 jar 1/ 2 jar 1/ 2 jar

Th e r e a f t e r : 1 jar  Carr o t s  Peas  Sq u a s h  Gre e n Be a n s  Swe e t Pot a t o e s

or

DI E T SC H E D U L E 6 - 1 2 M O N T H S 2 0 o z / d a y fo r m u l a 6: 0 0 a m

Eg g , Cere a l, Ha m , Sa u s a g e or ch e e s e , Enf a m i l / B r e a s t


Milk 7: 0 0 a m 9: 0 0 a m 10 : 0 0 a m 12 : 0 0 p m 2: 3 0 p m 3: 3 0 p m 6: 3 0 p m

Ap p l e , Pea r, Pru n e , W h i t e Gra p e , Ora n g e , Peac h

WA TE R Fruit or Juice WA TE R Me a t , Ve g e t a b l e s , Fruit s , Past a For m u l a or Bre a s t Milk WA TE R Cer e a l , Frui t s, Ve g e t a b l e s Enf a m i l or Bre a s t Milk Ba t h e yo u r chil d Aft e r 6: 3 0 p m WA TE R ONLY 7: 0 0 p m - 8: 0 0 p m SLEEP CE R E A L Port i o n s 1st da y : A ta b l e s p o o n plu s m o t h e r ’ s mi l k , for m u l a or wa t e r . 2n d da y : Tw o ta b l e s p o o n s plu s m o t h e r ’ s mi l k , for m u l a or wa t e r . 3r d da y : Thr e e ta b l e s p o o n s plu s m o t h e r ’ s mil k , for m u l a or wa t e r . Th e r e a f t e r : Fou r ta b l e s p o o n s pe r ser v i n g .  Rice Cere a l  Barl e y Cere a l  Oa t m e a l Ma y sta r t pas t a as cer e a l at 12 p m or 6: 3 0 p m

VEGE T A B L E S 2.5 oz Jar Porti o n s 1st da y : 1/ 2 jar 2n d da y : 1/ 2 jar 3r d da y : 1/ 2 jar Th e r e a f t e r : 1 Jar  Carr o t s  Peas  Sq u a s h  Swe e t Pot a t o e s I N F A N T JUICE S :

DI S C L A I M E R : ALL T H A T IS W R I T T E N I N T H I S PA M P H L E T ARE RE C O M M E N D A T I O N S T H A T O U R PR A C T I C E BEL I E V E S A N D UP H O L D S I N O R D E R TO HE L P P A R E N T S W E L C O M E T H E I R NE W A D D I T I O N A L M E M B E R O F T H E FA M I L Y A N D BY N O M E A N S CLA I M T H A T T H E S E REC O M M E N D A T I O N S ARE F O R E V E R Y CH I L D .


Th i s b o o k w a s w r i t t e n a n d cr e a t e d by Jose M . Ru b , M . D . a n d Be n y Ru b , M . D .


Hospital in NY and University of California at Irvine. Dr. Beny is a Fellow of the American Academy of Pediatrics and is Board Certified. He and his wife Marta have 3 children. During his spare time, you will find him on the tennis court or spending time with his family.

Rashida N. Joemmankhan, P.A.-C.

Bianca T. Vega, P.A.-C.

R U B PE D I A T R I C S M D PA RUB PEDIATRICS MD PA - MEDICAL STAFF

www.r u b p e d i a t rics.co m

J. Mark Rub, M.D.

Born in Peru, Dr. Mark studied medicine at Universidad Peruana Cayetano Heredia. He trained in Pediatrics at North Carolina Moses Cone Hospital, University of North Carolina. Since 1989, he has been practicing pediatric medicine at Rub Pediatrics MD PA. He is a fellow of the American Academy of Pediatrics and is Board Certified. Dr. Mark is also former Chief of Staff and former Chief of the Dept. of Pediatrics of North Shore Hospital. Dr. Mark and his wife Eva have 3 children. During his spare time, Dr. Mark enjoys windsurfing, soccer, and walking.

Beny Rub, M.D. Dr. Beny has been practicing pediatric medicine since 1990 at Rub Pediatrics MD PA. He studied medicine at Autonomous University of Guadalajara. He trained at North Shore University

BA B Y BO O K


Wri t t e n by: Jose M . Ru b , M . D . a n d Be n y Ru b , M . D . N o r t h Sh o r e M e d i c a l Ar t s Buil d i n g 1 1 9 0 N . W . 9 5 th St r e e t , Sui t e 4 0 9 M i a m i , FL 3 3 1 5 0  3 0 5 . 6 9 6 . 9 4 9 0 Bis c a y n e M e d i c a l Ar t s Buil d i n g 2 1 1 1 0 Bis c a y n e Bo u l e v a r d , Sui t e 3 0 8 Av e n t u r a , FL 3 3 1 8 0  3 0 5 . 9 3 2 . 1 0 0 7 Fa x : 3 0 5 . 6 9 6 . 6 2 2 5

 inf o @ r u b p e d i a t r i c s . c o m

Baby Book - Welcoming your Baby  

Written by Drs. Jose Mark and Beny Rub to help parents when they bring their new baby home.