Top 10 Things that are Normal in Newborns

Happy BabyBabies are cute; there’s no denying it.  But our mental picture of what a baby “should” look like comes from glossy magazine photos of babies between six and nine months old.  When your baby is born, he or she will look very different.  Your newborn will also act different than older, more settled babies.  Some of these natural adjustments to living outside the womb can concern parents.  The following list provides a head-to-toe guide to what’s normal for your newborn baby.

1.  For starters, your baby, especially is she is your first born, may have a cone-shaped head after traveling through the birth canal.  The bones of the skull are designed to ride over each other during labor; afterwards, the head gradually rounds down again.  Labor can also cause swelling and bruising on the scalp, which resolve in the first weeks after birth.

2.  It’s okay if your baby’s eyes cross.  Over time, your newborn will develop the fine-tuning he needs to move his eyes together and focus on things.  But make no mistake: your baby sees quite well immediately after birth and focuses best on objects that are nine to fifteen inches from his face.  Sometimes a blood vessel in the whites of the eyes breaks from all the pushing during labor, and you may notice a patch of red.  These subconjunctival hemorrhages are common and resolve completely.

Many babies have eyes that water or accumulate mucus.  Rarely, this can be a sign of a serious infection such as chlamydia or gonorrhea.  The most common cause of gooey eyes, however, is the small diameter of the tubes at the inside corner of the eyes that drain the tears.  These tear ducts grow as your baby grows, and by the first birthday this problem will take care of itself.

3.  Newborn noses are sneezy and stuffy by design.  Sneezing is a reflex that clears the nose; it’s not a sign of a cold.  Your baby’s tiny nostrils are easily blocked by mucous, and it will take a few months before he learns how to breathe out of his mouth when his nose is clogged.  Until then, clean his nose before he nurses or tries to sleep with the bulb syringe from the hospital and salt water drops.

4.  Hiccuping, like sneezing, is a reflex.  Your baby may have hiccuped quite a lot before she was even born.  Hiccuping spells diminish over time, and it’s often helpful to let the baby nurse when hiccups strike.

5.  When your baby yawns or cries, you may notice small, white nodules on his gums or the roof of his mouth.  These harmless collections of keratin are called Epstein’s pearls, and they will wear away.  Your baby can also have sucking blisters on his lips.  These can dry and peel and dry and peel again.

6.  Most babies have dry patches of skin that peel shortly after birth.  Peeling is the result of spending nine months in water, and no cream or lotion will speed up the process.  Newborns also have a common rash with an uncommon name: erythema toxicum neonatorum.  The rash looks like tiny bug bites, and it comes and goes for a few days before fading.  By the time the bug bite rash fades, you will start to see baby acne.  These little bumps on the face, chest, and back are caused by the pregnancy hormones.  Clean your baby’s face with warm water, and by the time the acne fades, she will have enough head control for her first formal photograph.

7.  The umbilical cord can take a week or two to fall off.  Clean around it with alcohol on a cotton swab, making sure to get at the gooey parts at the base.  Cleaning the cord more than four times a day can slow healing.

8.  Whether your baby breast feeds or formula feeds, you can expect up to three months of tummy troubles with gas and straining.  You wouldn’t expect your newborn to pick up a pencil and write his name any more than you should expect his digestion to progress flawlessly.  Breast-feeding mothers should modify their diets according to the pediatrician’s recommendations.  If mothers avoided all the foods that supposedly make babies “fussy,” there would be nothing left to eat!  Likewise, consult your pediatrician before changing formulas.

Once feeding is established, a healthy baby can have a bowel movement anywhere from twelve times a day to once a week.  As long as your baby’s stool is not hard, little balls, he’s not constipated.

9.  In the first days, you may notice a brick red tinge to your baby’s urine.  Newborn urine is concentrated, and urate crystals cause the red color.  Little girls can also have a milky vaginal discharge or some vaginal bleeding–like a mini-period–caused by the hormones of pregnancy.

10.  Baby legs are not straight because they’ve been curled up tight in the uterus.  As your baby stands and jumps on his legs, he will strengthen muscles and straighten bones.  Special shoes, bars, and casts are rarely needed.

There are many more things that are normal in the newborn period–too many for most lists and books.  Your pediatrician doesn’t expect you to learn everything about pediatrics in a few weeks, so call if you have any questions about your new baby.

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Saying Bye-Bye

Teddy BearWe say goodbye all the time–some of those separations are brief, others longer, some longer still. Parents of a new baby can learn about Separating-from-Infants-and-Toddlers in this article.

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My Kid Ate a Bug!

spiderI’ve been a spokesperson for the American Academy of Pediatrics since 2003, and I get calls and emails from reporters all the time, and this was a fun one to do. My Kid Ate a Bug Should I Freak Out?


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Baby Entertainment

happy-babyWondering if you are doing enough to keep your baby–newborn or otherwise–entertained? Check out the interview I did with the Bump on this topic here.



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Play and Explore with Babies and Toddlers

Rules of Poop What to do with baby? Explore the world! Find great ideas from the Bananas Childcare Bunch here.



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The Drink Pyramid

Almond Milk

The Drink Pyramid is a nice way to think about what you drink. Check it out here



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Best Squirrel Nutrition


This ad on the shuttle buses in Zion National Park made me smile.



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What’s the Difference Between a Sports Physical and a Yearly Physical?

First Aid Neon

As more schools and quick care outlets offer Sports Physicals, we felt that we should explain the difference between a Sports Physical and a Yearly Physical. Many adolescents and their parents believe that a Sports Physical is equivalent to a Yearly Physical, but this is not true. The Sports Physical is designed to clear an athlete for participation in sports while the yearly physical is more comprehensive.

A Sports Physical usually includes a physical examination and a brief discussion of the child’s medical history. Developmental and immunization histories, long-term health concerns and risk factors, and advice for developing a healthy lifestyle are not reviewed during a Sports Physical.

The Yearly Physical usually includes a complete physical examination (including vision and hearing screening), a discussion of the child’s medical history, weight, height and body mass index, childhood nutrition, sleep habits, physical development and activity, social development and activity, cognitive development and academics, risks to health and safety, status of chronic conditions, immunization update, preventive health recommendations, cholesterol and anemia check, and adolescent issues. It is also our opportunity to discuss important topics such as peer pressure, avoiding drugs, tobacco and steroids. It helps us to develop an open, trusting relationship with you and your child so you can turn to us with questions or concerns regarding puberty, normal development or any medical concerns.

To summarize the difference, there is no such thing as a quickie physical or just a simple Sports Physical. Eliminating recommended components of the Yearly Physical is poor quality care. We follow the American Academy of Pediatrics Bright Future recommendations for well care. The people doing the Sports Physicals do not follow these guidelines.

Pricing Differences

With the insurance regulations now in effect, most insurance companies will pay for the Yearly Physical examinations without a co-pay. This, of course, depends on your individual policy and we suggest you contact your insurance company if you aren’t sure what your policy covers. Some insurance companies allow these once a calendar year; others allow them once every 365 days. Schools may charge a fee to perform the Sports Physical stating that it is “cheaper” than going to see your regular doctor. They also may say that a percentage of the fee will be donated back to the sports program at the school. The reason they charge this fee is because most insurance companies will not pay for a Sports Physical because it simply doesn’t exist and is not recognized as good care for the patient. If this was good care, then the insurance companies would not hesitate to pay because it would be cheaper for them than a full Yearly Physical. Honestly, if you want to donate to your child’s sports program at school, we recommend doing this in some other way that doesn’t potentially compromise your child’s health.

Filling out School Forms

If you need to have a participation form filled out, and your child has had a Yearly Physical examination in the past 12 months, we can complete this form for you without your child needing to have any other type of physical done. We will complete the form based on the most recent yearly physical examination. If you drop off the form, please fill out any sections that are “parent” sections. We cannot fill out our part unless your section is completed first. Please allow 7 business days (Monday-Friday) for your form to be completed. If you require the form sooner than the 7 business days, please call our office to ask about that the charges for urgent requests. If you do not have a Yearly Physical done in our office, we will not be able to complete any forms you might need at any other times during the year, including camp forms.


What we require

Casa Verde Pediatrics wants your child to be as healthy as possible. We feel that regularly scheduled Yealry Physicals help to ensure that your child is growing and developing well. These visits allow us a chance to find and treat any concerns early. In order to remain an active patient with Casa Verde Pediatrics, we ask that you bring your child in for a Yearly Physical examination. These visits help your child learn how to take responsibility for their own healthcare.


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This Fall It’s a Shot in the Arm

Shot Time The American Academy of Pediatrics is recommending flu shots for the 2016-2017 winter season and not the intranasal flu vaccine after studying the different products. Our office ordered flu vaccines in February of 2016 and will update families and patients as our flu vaccine supplies arrive. Read more about the decision from the American Council on Immunization Practices here and the CDC’s information here.

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Button Batteries

Button_Battery.jpgButton Batteries: they’re in everything from toys to hearing aids to thermometers and key fobs to remote controls. Don’t let them get inside your baby or child.

Always secure the screw to draws that hold button batteries. Keep them away from the kids at your house and grandmom and grandpop’s.

If you think your child may have ingested a button battery, call your pediatrician. If your child is drooling or having difficulty breathing or swallowing, call 911. Button batteries can cause serious burns to the intestines and bleeding.

Teach your child never to put anything in their ear or nose. That includes cotton swabs and fingers. Button batteries in the ears and nose can cause severe damage.

Get rid of used batteries at recycling spots in your community. Find out how and where here.

Read more about safe use and disposal of button batteries from the American Academy of Pediatrics here.

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