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Helen Dandurand (Host): Welcome back to the Well Within Reach podcast, brought to you by Riverside Healthcare. I'm your host, Helen Dandurand. And joining me today is Dr. Zain Talukdar, a pediatrician at Riverside Healthcare, who is here to talk about preparing to have a newborn in the house. Welcome, Dr. Zain.

Dr. Zain Talukdar: All right. Thank you for having me. I'm really excited to join.

Host: Of course. Could you start by telling us a little about yourself?

Dr. Zain Talukdar: Yeah, sure. So, I come from a first generation immigrant background. My parents are from Pakistan and Bangladesh and South Asia. I'm the first in my family to go to college and to become a doctor. I did my college training in Swarthmore College near Philadelphia. i went to med school at the University of Rochester, near Niagara Falls, and then finished my residency at the University of Chicago. And now, I'm a pediatrician in an amazing community, in Riverside.

Host: Oh, that's great. We're so happy to have you here, growing the team. So, the topic at hand today is preparing to have a newborn in the house. Very relevant for some of us here. So as a pediatrician, what is the best advice for parents that you have as they prepare for bringing home a newborn for the first time?

Dr. Zain Talukdar: I want to start by saying that I think all of my questions will not have enough time to be able to address them, because this is such a big topic, and I can honestly go for hours about any of these.

So, I'm going to try to keep the points to, like, the really big, high-yield ones. But for the best advice that I could give is to normalize some of the feelings that comes with it. It's very normal to feel nervous, to feel scared, to feel like, "I don't know what I'm doing. This is so overwhelming." This is probably one of the biggest, if not the biggest, transition in your life. And it's completely okay to feel those feelings.

It's also normal to feel like I don't know what I'm doing as a parent. I want to make sure I'm doing the best for my kid, but I just don't know what to do. This is in our hardwiring as human beings to care for our children. But it's also okay as part of that to ask for help, whether it's another family member or even your pediatrician or your own doctor.

Host: Yeah. I think that's great to know. I guess, in the past, I haven't necessarily thought of how my pediatrician could help, you know? I mean, I don't have kids yet. But you know, that a pediatrician has all that wisdom and can help you out, and be a good trusted source for you. If you have questions and if you are nervous and things like that. So, that's really good to know.

So, we're going to talk a little bit about baby products. There are so many things on the market. What kind of items do you consider to be, like, true essentials, and what do you think you've heard of people talking about and you're like, "Okay, you could skip this"?

Dr. Zain Talukdar: So, I want to give a preface that I don't have kids myself yet, but my sister has had kids, my best friends have had kids. And now, being a pediatrician, this topic comes up all the time, and there are so many products out there that are marketed as absolutely necessary and will prey on the guilt that you feel for not having that. And so, I think a lot of the things that I'm going to focus on are about safety, but this is not a comprehensive list at all.

So obviously, you need to have a crib or a bassinet, somewhere for the baby to sleep. It needs to be firm, so it has to have a firm crib mattress, preferably one that's flat, and then have the sheets and the blankets for the crib as well. Make sure that those fabric material is cotton, and not fleece. You're going to need a car seat to leave the hospital with your baby. So, definitely make sure to have that. We all know we need diapers. So, make sure you have a lot of those, and then maybe a size up or two sizes up so you're ready for your baby to grow. Happens faster than you realize. For temperature checks, make sure that you have at least one or two thermometers, and preferably one that you can use for rectal temperatures, because that's more accurate for babies.

For any laundry detergents, I would recommend keeping that on the safe and gentle side. So, gentle laundry products. For pumping, I would recommend, outside of having the pump, also having somewhere to store the milk. And for bottles, I would also recommend having bottle brushes with the bottles. The sterilizers and warmers that are marketed are not mandatory.

If you want to get them, you can. And then, one thing that comes up a lot is having diaper paste, like Triple Paste ready in case the diaper rashes happen, because it can happen really quick. I saw a baby who had a diaper rash at four days old. So, it could happen anytime. There's so many things I'm missing, but these are kind of some of the big ones that come to mind.

Host: Great. Those sound like some really good essentials to make sure that you have taken care of and you have the right things. You did mention the crib and bassinet, and I know that the safe sleep recommendations have kind of changed over time. Can you walk us through the current guidelines and explain why they're important?

Dr. Zain Talukdar: A hundred percent. It's a really important topic. And it started because we've noticed in the US that there have been increases in the amount of what's called sudden infant death syndrome, which sounds scary, and it is scary. We call it SIDS. You'll also see SUID, sudden unexplained infant death. We have roughly around 3,500 infant deaths a year in the United States.

So, our guidelines, which were most recently updated, at least I saw, in 2022, mention the ABCs. If you can't remember anything, remember the ABCs: alone, back, and crib. So, alone meaning that the baby is alone on the crib, and it's not full of objects. Usually, we just recommend having the blanket, maybe the pacifier is okay. But otherwise, no extra toys, no extra blankets, just whatever they need to sleep. Placing them on their back to sleep, not on their tummy, and not sharing the bed. And then, also making sure if you do tummy time, that you only do it while they're awake. So, back while you're sleeping. And then C, crib, making sure they're on a crib or bassinet. Not a sofa, not a bed, and preferably not on the floor as well.

There are also some factors that can help decrease the likelihood of SIDS. One is exclusive breastfeeding, and that also is a very personal decision, and one, as a pediatrician, I will not push one way or the other. We'll work together to come up with a feeding plan for your baby. But exclusive breastfeeding has been associated with decreased rates of SIDS. Sleeping in the same room, but not in the same bed, has also been helpful. And the updated guidelines actually do take into account the cultural considerations that comes from being part of a more collectivist culture, where very close interconnected family dynamics are normalized, and that includes co-sleeping. But they still recommend from a safety perspective to avoid sleeping in the same bed, which is where the idea of sleeping in the same space or the same room comes in. But it's just really important to make sure that they have their own independent place to sleep that's flat, firm, and not having other objects in it.

And then, the other thing that I would say is any kind of smoke exposure, whether it's marijuana smoke, vaping smoke, and cigarette smoke, any kind of smoke is associated with increased rates of SIDS. So, I would be careful around any of that.

Host: Yeah, I think that's all really good info. A lot of different information comes out, and research happens, and things change, so I think staying up to date on that is super important. What can parents do to help keep their newborn healthy during those first few weeks, especially when you have family and friends that want to come over and visit?

Dr. Zain Talukdar: This comes up all the time. And I don't think I've met a parent that hasn't been nervous about bringing this up to other loved ones. What do you do when grandma, or auntie, or your best friend is like, "When can I see your baby?" And it's hard, because as the parents, you have to set the rules. And part of our recommendations is that we help with those rules, reinforce those rules. So, a lot of it comes down to infection prevention and safety, because babies are not as good at fighting infections as older kids and adults at all. So, hand washing is very important. Anyone who's going to be around the baby should wash their hands when they enter the house. Having hand sanitizers kind of throughout your house, but especially near your front door as a visual cue is very, very helpful as well.

And usually, it helps to know who your inner circle is going to be those first few weeks, meaning who are going to be the few people that can see and hold the baby. And then, enforcing outside of that, that, "Hey, it's just not the time for us to see other people. We need the privacy, but also for the baby's safety." That's completely okay, and there's nothing wrong with doing that. Part of it, too, is setting the rules for the people that are able to see the baby. No kissing the baby, and anyone that's sick, even with, you know, a lingering cough or a cold, they should probably not be around a newborn baby, at least for the first few weeks.

And then, going back to the idea of smoking, making sure that if anyone in that inner circle is smoking, that when they come back, they change their clothes and they wash their hands, because babies are very, very sensitive to secondhand smoke, and that includes the lingering smoke on your body or on your clothes. And then, from a vaccine perspective, I usually recommend that anyone that's around a newborn baby has at least the TDAP and the flu shots, because babies can get very sick from the flu and from pertussis, and pertussis is part of the TDAP series.

Host: Okay. I feel like that's really helpful. Do you have a recommendation, too, if parents are wanting to get their kids out of the house, when do you feel like is that more safe, considered more safe?

Dr. Zain Talukdar: That's a good question. And I think there's a little bit of wiggle room there. The part where there's not a wiggle room, I would say, is the first month. Because babies, if they had developed a fever in the first month, we treat that as a true emergency. After the first month, we lax a little bit on that, and we start have doing what's more shared decision-making, meaning the doctor and the family can come up with a plan together.

So, I'd say if your baby is under one month, I would be pretty strict. If your baby is over one month, I would talk about the specific situations with your pediatrician and come up with a plan. And then, as they start getting closer to two to three months, you can start introducing them to more of the world, more of your larger secondary circles. And you can still enforce whatever rules you need to because, again, they're still your kids first.

Host: Yeah. Well, thank you so much. Okay, we're going to take a quick break to talk about primary care at Riverside.

At Riverside, our primary care providers are right here in your community, offering personalized care for you and your family, close to home and connected to the specialists and services you may need.

Having a primary care provider means having someone who knows you, listens to you, and helps you stay well through every stage of life, from annual checkups and preventative screenings to managing everyday concerns when they pop up, because remarkable care should never be out of reach. Remarkable care right where you live.

To find a primary care provider who's right for you and your family, visit myrhc.net/acceptingnew.

Okay, and we are back. What are some of the most common questions and concerns that parents call your office about during that first month, and what kind of advice is usually given?

Dr. Zain Talukdar: So, some of the more common questions that I've seen already since starting at Riverside and in residency kind of have to do around managing different symptoms, like, "What do I do if my baby's warm to touch, or if they're vomiting, or if they start acting different?"

And what I typically will say is kind of universally trust your gut if you feel like something is wrong, and call your pediatrician if you're really not sure. There's no such thing as too many questions, especially in that first month. There's no such thing as a stupid question ever, but especially when you have a newborn baby. And that's part of why we have call offices and triage centers in our clinic because they will help kind of guide you to the right direction, whether it's coming to see us the next day, or going to the ER, or one of us getting on the phone with you to talk through more of what the baby's experiencing.

And then, generally, there are some things that we look for for a baby that I would recommend at that point just going straight to the ER, and I would hold onto these, if your baby has a true fever over 100.4, but through a rectal temperature, that's a true fever, or if your baby's temperature is under 97 rectally; if your baby's floppy or really tired and lethargic, and I use the word lethargic knowing that the pediatric community uses that word very seriously; if your baby's not eating at all, or if your baby's completely inconsolable, I think that's when you say, "Okay, I'm just going to go straight to the ER."

Host: That makes sense. Are there some things that are considered normal but that a lot of parents have questions about, and when would that be like, "Oh, should you see your pediatrician about those?" Do you know what I'm talking about?

Dr. Zain Talukdar: You know, it's so funny you say that because I just saw a video on Instagram, and I don't remember, like, who it was from, but it was this video about newborn visits at the pediatrician where the pediatrician's like, "Oh, your baby has like a 14th thumb near their belly button? That's normal. That's just what babies do." And I thought that was really funny because there actually is a really wide breadth of things that babies just do. Babies are weird. They are not like older kids and adults. Everything is immature. Their skin is immature. Their immune system's immature. Their neurons are immature, and their blood vessels are immature. So, a lot of the things that you see kind of have to do around the inner mechanisms of their body being immature, and that's where we step in. That's why we get this training as pediatricians, so we can tell what is just a normal newborn thing versus something that we haven't really seen before that we have to keep an eye on versus something that we need to act on right away.

I'd say, for the most part, trust your gut. If you're like, "I've never seen this before, I want to get a set of expert eyes on it," totally fine. But if your baby is looking well and acting like themselves, and they have this rash, or they have this thing that you haven't seen before, they usually will be okay. But I know that's a very big generalization, so that's when you just ask us for help.

Host: Awesome. So, what should parents expect from those first newborn doctor's visits, and kind of why are they important?

Dr. Zain Talukdar: They're really important, especially in that first month, because babies grow so much. And you'll see it. If you take a picture of your newborn baby to your one-month baby, you're like, "It's a different person." And that's part of why we do all the visits. We also like to make sure that we can check on the mental health of the mom, to make sure that she's supported. We do regular depression screenings for all the visits leading up to the first six months.

And then, we check the baby's weight, we check their head circumference, we check how they're feeding, and we check in on the parents. We also will see sometimes babies can have jaundice or yellowing of their skin, and some jaundice is normal, but then you get to a point where it might not be. So, having the babies come in frequently in the first month is very important.

Host: Great. And I think my final question, are there any common myths about newborn care that you find yourself kind of correcting over and over within your practice?

Dr. Zain Talukdar: So, there are so many myths out there. I'm just going to list a few, but this is not exhaustive at all. There are so many. One that I just heard yesterday was, "Oh, yeah, adding a little bit of extra water or rice cereal to my baby's formula or breast milk won't hurt." But it will. So, it's a myth. We recommend exclusive breastfeeding, that's number one, or exclusive formula or a combo of the two for the first six months until they're ready to start solid foods. Nothing else added without the discretion of your pediatrician.

One is that a little jaundice doesn't hurt. We just talked about that. There's a good percentage of jaundice that won't hurt the baby. But if it's severe or it's been within the first day of life, that's something that we take pretty seriously. And also, the idea that babies can choke if they sleep on their backs, that's also just not true, and it's why we have that as part of our safe sleep guidelines. And I just wouldn't want a baby to sleep on their stomach because of a myth that grandma told you, you know?

Host: Yeah. Well, I feel like those are all really good things to kind of wrap it up here, for folks to know, new parents to know about. And I feel like this was pretty comprehensive. And we have great pediatricians here at Riverside, Dr. Zain included. So, they'll be your partner as you're coming home with your newborn, and your kids to help you to know, you know, what you need to be doing. So, thank you so much for joining us today, Dr. Zain.

Dr. Zain Talukdar: Yeah, of course. Thank you for having me.

Host: Yeah. And thank you listeners for tuning in to the Well Within Reach podcast. Be sure to like and subscribe to Well Within Reach on Apple, Spotify, or wherever you get your podcasts. To learn more about services at Riverside Healthcare, go to riversidehealthcare.org.