#neonates

Newborns like to just occasionally pause breathing and then do this weird 💩 called "periodic breathing" (NOTE: I include this only because the samples of the actual baby's breathing are very helpful to see; I don't necessarily endorse this channel or anything else said in this video and am not affiliated in any way) which just looks scary and ridiculous because their little immature brains haven't figured out that they're supposed to, y'know, keep breathing. It's just normal--until it's NOT?! Pro tip: These breathing pauses are normal UP TO 10 seconds MAX. Anything longer and anything repetitive (i.e. multiple episodes in a row of weird pauses like this) are concerning, especially if accompanied by: persistently fast breathing, subcostal indrawing, head bobbing (+/- tracheal tug since most neonates also have barely any neck so it's super hard to see for them), abdominal muscle use and/or paradoxical breathing, or cyanosis.

💩! Many parents are freaking out because their baby's poop changes colour. As a pediatrician, I give 0 💩s about what colour the baby's 💩 is UNLESS it is ⬛black, 🟥red, or ⬜white (clay-coloured). So, YES, 🟩green 💩 is actually FINE, and is usually a reflection of mom's diet (in breastfed infants), variations in a baby's gut flora, and sometimes inflammatory processes if your baby's fighting something off (e.g. a virus). So I would not be worried if your baby's 💩 is 🟩green unless their tummy is distended, they're also vomiting like there's a prize for it and/or they're dehydrated, they're losing weight, or they look unwell.

Speaking of 💩: it is NORMAL for a baby to poop more than once a day, sometimes more than 3 times a day, and sometimes once every 3 days. As long as your baby is growing and gaining weight well, their little tummies are soft and comfy, and their poops do NOT look like anything described in #2 (LOL), they are okay! Baby poop should generally look like seedy mustard, but can sometimes become sort of pasty like smooth peanut butter as they get older and start eating more solids. Anything that looks like a pebble in your baby's diaper is strange and warrants a visit to your baby's doctor, but is usually very easy to treat.

Okay, I think this is the last 💩 thing: You know how I said babies haven't yet figured out the art of breathing all the time? Some of them haven't figured out the coordination of pushing a poop out and relaxing their anal sphincters (poop outlet valve) yet, either. So they are pushing this poop with their tummies really hard while also squeezing the exit shut as hard as they can, which is, like, really uncomfortable. As long as your baby is growing well, has a nice soft, non-tender belly, feeds well, and looks totally normal and fine after they finally get the poop out, they are exhibiting a condition called "dyschezia" (basically doctor-speak for "baby-guts-and-anuses-haven't-learned-to-get-along-yet" syndrome). It is benign and will go away on its own as your baby grows up and its guts and anus reconcile and learn to get along. What can you do? Gently push your baby's bent knees up to their chest in a rocking motion (kind of like you're gently stamping the imprint of your baby's chubby thighs on their chubby tums), or gently alternate bending each knee toward their chest in a "bicycling" motion (as if you're using the arm part of the mountain-climber workout machine thingy at the gym). YOUR BABY WILL PROBABLY FART A LOT WHILE YOU DO THIS--THIS MEANS IT'S WORKING. THEY WILL PROBABLY LET OUT SOME SHARTS TOO--THAT'S WHAT YOU WANT TO HAPPEN. This is a team-building exercise between you, your baby's guts, and your baby's anus. Farting and pooping are evidence of progress.

You do NOT need to give your baby a bath every day; in fact, you shouldn't, since it can dry out your baby's skin. A bath every couple of days is sufficient (or after big poo-namis or vomit-ruptions), and you can moisturize baby's skin with any unscented baby lotion or just plain petroleum jelly (I do find greasy beans super cute but they are also a little slippery...).

MOST BABIES SPIT UP. Spitting up is technically physiologic because like their brains and literally everything else about them, the lower esophageal sphincter (read: their backflow-prevention valve at the bottom of their food intake tube that connects to the stomach) is underdeveloped. It's a newbie traffic officer in the first stretch of its job and it really doesn't know what it's doing yet, hence it will often let foodstuffs do a U-turn on what's supposed to be a one-way street... After about 4 months or so on the job, usually it gets its 💩 together and figures its life out. Who needs to be seen in the ER? Babies that have frequent LARGE volume spit-ups (e.g. >50% of their usual feed volume); have BILIOUS (🟩green) or BLOODY (🟥red/reddish brown🟫) vomit; whose vomit can literally be used as a cannon to hit unsuspecting visitors in the face from 3 feet away (i.e. projectile); who vomit so much that they can't actually keep down a feed; or who are vomiting so much they are dehydrated (i.e. less than 4 wet diapers in a 24 hour period). Who should see their baby's doctor? Babies who spit up frequently even after 4 months of age; babies who are not gaining weight or who are losing weight; babies who have other weird red flag symptoms; and babies who are very uncomfortable and mad when they spit up so they look like they're being inhabited by demons when they do.

Babies do a bunch of weird movement things that are totally normal. If it looks like this, it is something called the moro reflex that is a normal newborn response to sudden loud noises or sudden shifts in your baby's position (you may see your baby's doctor do a bunch of weird stuff to make your baby do this on purpose--don't worry, none of these maneuvers will hurt your baby). If they're doing OTHER weird movements, it's worth it to touch bases with your baby's doctor to make sure things are okay.

If your newborn (1 month old or less) has a fever, GO TO THE ER RIGHT AWAY. Do not pass "GO", do not collect $200, GO STRAIGHT TO THE ER. Babies between 1 to 3 months of age can also be at risk of serious infections and should see a doctor ASAP if they have a fever. Babies older than 3 months usually do not need to see a doctor within the first 24 hours of fever UNLESS you are concerned that your baby looks unwell or has other symptoms that freak you out, but WHEN IN DOUBT, HEAD ON OUT (to go to the ER).

BOTTOM LINE: If you're worried about your baby, I promise I am very, very happy to check them out in the ER. (I will not think any less of you!! New babies are stressful! And I love them 😍)