Maggie McKay (Host): Expecting a baby is such a special time, but it can also be overwhelming not knowing what to expect. So today, Dr. Katie McAnany, General Pediatrician in the Primary Care Clinic and an Associate Professor of Medicine at UMKC, will discuss what every parent should know about newborns. Welcome to the Parentish Podcast, where experts at Children's Mercy Kansas City talk about the little everyday things parents experience with their babies, teens, and in betweens.

I'm your host, Maggie McKay. Thank you so much for being here today, Dr. McAnany.

Katie McAnany, MD: Thanks for having me.

Host: Well, it's so true. I mean, there are so many things to know when you have your first baby. So let's just start with how often should you feed a newborn? And does this vary by breast milk versus formula?

Katie McAnany, MD: Yeah, newborn babies, they feed a lot. It is one of their main jobs. They're supposed to eat, sleep, breathe, and do bathroom, and that's literally it. Especially in those first few days of life, babies will cluster feed. I mean, you could be feeding them every 30 minutes, every hour, every couple hours. You really cannot nurse too often, but you can nurse too little.

If a baby is going for more than four hours between feeds, you should be waking them up. And between breast milk and formula, sometimes formula fed babies might go a little bit longer between feeds. That's because we're waiting for mom's milk supply to come in. She's only producing a few milliliters of colostrum, that nutrient rich milk, at first, in the first few days.

But that is totally enough to satisfy baby because their stomachs are so little.

Host: And so how much should they eat? Is there a specific number of times per day, ounces, length of nursing session, et cetera?

Katie McAnany, MD: So, newborns are just learning how to eat. An average session might last 15 to 20 minutes at a time. They might go longer or shorter. Don't focus on the numbers. Focus on that satiety of the baby. So, if the baby is sleeping afterwards, looks comfortable; it doesn't matter if it was a five minute session at first or a 20 minute or an hour session, we're going for satiety there.

They might take one ounce at a time, they might take up to three, but remember that stomach is super small. It's the size of an acorn when they're born, so there's really not much that's going to be able to fit in there.

Host: How often do newborns sleep? How do I know if they're getting too much or too little sleep? I was always like a nervous wreck thinking he's still asleep.

Katie McAnany, MD: Yeah, I mean, if you, have just been through this trauma of birth, they sleep a ton. They can sleep up to 18 hours a day. It is a lot. Unfortunately, not all of that is at the same time. So they might only sleep 30 minutes at a time, up to an hour at a time and especially cause they're feeding constantly.

So, if they're sleeping longer than four hours at a time, they should be woken up. But no, that's one of their four main jobs, eating and sleeping and peeing and pooping, and breathing. So, really, they can't sleep too much, really.

Host: Another nerve wracking thing for parents, I think, at least for me was how do you keep your newborn safe while sleeping?

Katie McAnany, MD: That's a really important question. It's like one of the best things we do as a pediatrician is helping families keep their babies safe while they're sleeping. So if you could remember one thing, it's to remember your ABCs. Babies should sleep alone on their back in a crib. So alone for A, B for back, and C in a crib or bassinet, whatever you have at home.

There should be nothing else in the crib. No pillows, no blankets, no swaddles that are like loose. You could have a tight swaddle, and a baby should never sleep on an adult mattress or anything other than their crib or bassinet. And the reason why we do this is to reduce the risk of Sudden Infant Death Syndrome, or what we call SIDS.

But again, if you're following those ABCs, the alone, on your back, in the crib or bassinet, your baby will be safe while they're sleeping.

Host: Dr. McAnany, what are some good soothing techniques for a newborn?

Katie McAnany, MD: Yeah, that's tricky too, because, especially if you're a first time parent, you're just learning all of this as you go. I like to remember the five S's is my soothing techniques. That's going to be sucking, swinging, swaddling, side lying or stomach lying, and then shushing. So sucking, what I mean by sucking is sucking on a breast, bottle, or pacifier.

This is going to like lower the baby's heart rate, blood pressure, and stress levels. So any kind of sucking will be great, usually that involves feeding. Swinging, so if you're holding a baby, rocking it, kind of jiggling their bottom can kind of help. This kind of recreates the feeling of being in the womb.

Swaddling, so a very tight, burrito like swaddle can recreate being in the womb. So keeping those arms tight next to the baby's body. And then what I mean by side lying or stomach hold. So if you hold the baby like on your arm, with the stomach down and rock them side to side, or if you put them on their stomach but not while they're sleeping, that can also relieve some of that pressure on their belly.

And then finally shushing. So shushing sounds, that sh sh sh can help mimic the blood flow from the womb and also calm down the baby.

Host: And what immunizations do newborns need, if any?

Katie McAnany, MD: So right off the bat when you're in the hospital,all newborns should receive the hepatitis B vaccine.

 This is to prevent blood borne diseases if they were ever to, hopefully never, need a blood transfusion. While it is not technically a vaccine, we also recommend that babies receive vitamin K. This is injected like a vaccine, but it's just a vitamin. This is because infants are born with low vitamin K, and it's an essential part of blood clotting.

So, you've just had a traumatic birth. God willing, this would never happen, but if there was a bleed or any kind of hemorrhage, vitamin K would be able to prevent, something traumatic from happening.

Host: That's good to know. how can I play with my newborn to help their development?

Katie McAnany, MD: In these first few months of life, there really isn't a lot you need to do to baby other than just to respond to their needs. Responding to their needs is the best way to help their development. So feeding them, rocking them, soothing them, holding them. You cannot spoil a baby by holding them.

Babies bond by being held. So the more you hold them, the better. So yeah, you do not need to listen to grandma. You can hold that baby as much as you want. Talk to your baby, sing to them. She knows your voice and she'll respond to it, the more you talk to her and love on her. So there's not like a specific way to play with your baby, but just responding to their needs is the best way to help their development.

Host: Is there any research that proves that babies recognize the voices of, say, their parents when they come out because they heard their parents talking when they were in the womb?

Katie McAnany, MD: Absolutely. I don't know about specific, like, data based research, but, we know that babies, they'll track family members, that they'll respond to the voices of the people that have been around them, especially the mother and the father, and siblings, and grandparents that have talked to the baby when they're in the womb, so they're more responsive to those voices, so yeah, if you're talking to your baby in the womb, and actually just talking out loud. Right now, I'm 38 weeks pregnant. So, you know, my baby's listening to my voice right now and she'll know me when I deliver. And anyways,

Host: Congratulations. That's exciting.

Katie McAnany, MD: Yeah I know this is a very relevant podcast for me.

Host: Yeah. Oh, that's awesome. Yeah. When, when our son when he arrived, the first thing, my husband said, he whipped his head and looked straight at him and I'm like, wow.

Katie McAnany, MD: They know, they know their voices. There's not much of a barrier between their ears and the outside and the dads and the moms are the people that are talking to the babies all the time.

Host: Better say all positive stuff, right?

Katie McAnany, MD: Yeah, yeah, say nice things.

Host: Anything else you'd like to add?

Katie McAnany, MD: I just really want to support parents in this really vulnerable time, especially those first time moms and dads. It's really a challenging, steep learning curve. And you hear a lot of voices with a lot of different opinions. So, listen to your gut as a new mom and a new dad, ask those good questions, there are no dumb questions, reach out to your pediatrician if you need help or support, and just know that you're doing a good job and you'll get through this challenging time.

Host: Right. Just love your baby, right?

Katie McAnany, MD: Love your baby every day.

Host: Yes. Well, congratulations on your pregnancy and thank you so much for joining us. This has been so helpful.

Katie McAnany, MD: Absolutely. Anytime.

Host: Again, that's Dr. Katie McAnany. And if you'd like to find out more, please visit childrensmercy.org/parentish. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you.

I'm Maggie McKay. Thanks for listening. That concludes this episode of the Parentish podcast. For more parenting tips and tricks, visit us at parentish.org, where we help you celebrate the craziness and challenges of parenthood.