Fever with rectal temperature of 100.4 F or over(Do not give Tylenol/Motrin before notifying us).
Vomiting repeatedly (not just spitting up) or refusal of food several times in a row.
Excessive crying without obvious cause
Listlessness/not waking to feed
Frequent loose, fluid bowel movemt (mucous and foul odor).
Unusual rash (not just prickly heat rash).
After hours - call the physician on call at 716-298-4454.  The operator will page our medical staff person on call.If you have any concerns, please do not hesitate to call.  Our staff is eager to meet your needs.
Your child is an individual from the day he/she is born.  Adapt these suggestions to your baby. We will be happy to give you guidance and answer your questions, while you are in the hospital and later by the phone and during your visits to the office.  Doctors and staff are available everyday 24 hours, 7 days a week.
Getting To Know Your Baby
     There should be no visitors the first days at home.  The first 24-48 hours at home should never be expected to
be "smooth sailing." Both you and your baby will fare better if you have time to adjust to new circumstances and to one another.

    Limit visitors during the first few weeks because a new born baby has had no time to build up a resistance to infections, which can be easily transferred to him/her.  Discourage people from holding your baby.  There'll be lots of time for that later on.

Preventative Measures:
     Limit number of visitors, they should not be ill, everyone should wash their hands before holding your baby, keep your baby at home the first 2 months, do not to take him/her out to malls or grocery supermarkets and avoid crowds of people.
Congratulations on the birth of your baby! All of the staff at Summit Pediatrics look forward to caring for your child. We welcome any questions you may have. We hope this brief guide makes your early days a little easier.
   Please contact us with any questions or concerns.  Our lactation consultant,
Patricia Iacovitti, PNP,IBCLC, will be happy to speak or meet with you and your baby.
Bottle Feeding
     Seated comfortably and holding your baby with his/her head supported, tilt the bottle so that the neck of the bottle and the nipple are always filled with formula.  This helps your baby get formula instead of sucking and swallowing air.  Air in his/her stomach may give your baby a false sense of being full and may also make your baby very uncomfortable.  If our baby doesn't waste energy sucking air, he/she is more likely to take enough formula and be satisfied.

    Your baby has a strong, natural desire to suck.  For him/her, sucking is part of the pleasure of feeding time.  Babies will keep sucking on nipples even after they have collapsed.  So take the nipple out of your baby's mouth occasionally to keep the nipple from collapsing,  This makes it easeir for him/her to suck , and rest a bit.  Many bottles made now allow for air escape from the bottle while the baby is sucking, thereby avoiding this issue.

    Never prop up the bottle and leave your baby to feed.  The bottle can easily slip into the wrong position.  Remember, too, your baby needs the security and pleasure to be held at feeding time.  It's a time for both of you to relax and enjoy being together.

    Burp your baby after ten minues of feeding and again after feeding is complete.  Even if he/she is fed properly, baby usually swallows some air.  The way to help him/her get rid of air is to burp your baby.  Hold our baby upright over your shoulder and pat or rub his/her back very gently until he/she lets go of the air.  Or, Place your baby face down over your lap and gently rub his/her back.   After feeding, sit your baby upright for at least 30 minutes.

Office Visits

Your baby should have his/her first office checkup when he/she is 1 week old unless your baby needs our attention before then.  For example jaundice, not feeding well, not waking for feeds, vomiting, etc.
   Sometimes new mothers are a little unsure of themselves.  As long as your baby is well fed, warm, comfortable and has tender loving care these few simple infant care instructions should help you to relax and enjoy your baby.  The most valuable thing parents can do for themselves and their children is to enjoy them.

     Your baby will do things all babies do,.  They sneeze, yawn, belch, have hiccups, pass gas, cough and cry.  Occasionally they look cross-eyed.  Sneezing is the way babies clean their nose of mucus.  Hiccups are little spasms of the diaphragm muscle.  This may often be stopped by giving a few swallows of warm wter.  Coughing is their way of clearing their throat. Crying is their way of saying "I. hungry, I'm wet, I'm thirsty, I'm too hot, I'm too cold, I have a stomachache or I'm bored. " Gradually, you will know what your baby means.

    Almost all infants have a fussy period which frequently occurs in the late afternoon or evening, hopefully not at night.  This is not colic, but a normal phenomenon for which there is no explanation.  Colic typically appears within the first two weeks and is known to often disappear suddenly.

Passive Smoke - Do not let anyone smoke around your baby.  Living in an environment of passive smoke is a SIDS risk factor.
Sleep Position - Recommended sleep position is on the back.
Never leave your baby unattended on an elevated surface whether laying or in a car seat or bouncy seat (bed, couch, chair, etc.).   Even though a newborn is not able to deliberately roll over, accidents do happen.
Water Temperature
Set your tap water temperature at the water heater at 120 degrees.
Smoke/Carbon Monoxide Alarms
Have functional smoke alarms and Carbon Monoxide alarms with fresh batteries in the recommended locations in your home.
If Formula Warming Desired:
    Just before feeding, remove a bottle from the refrigerator ande warm it in a pan of ho (not boiling) water for a few minutes or, if you desire, you may use a bottle warmer
Test the temperature of the formula by shaking a few drops onto the inside of your wrist. It should feel warm, but not hot. Do not microwave formula as this results in inever heating and could burn your baby's mouth.

Test Nipples Regularly
    Testing nipples regularly will save time when you're ready to feed your baby. Nipple holes should be the right size to help your baby suck easily.  When the nipple holes are the right size, warm milk should drip at a moderate rate without forming a stream.
After feeding is done sit your baby upright for 30 minutes, then after you have burped your baby, place him/her in its bed. Your baby should sleep on its back and not on its stomach.
    After bottle-feeding, rinse bottles and nipples with cool water.  This removes milk before it forms a film and makes washing easier.  Squeeze water through the holes of the nipples as you rinse them.  Washing can be done later, whenever it's convenient for you.
    It is not necessary to sterilize bottles.  They can be run through the dishwasher Sanitary Cycle. You only need to boil water for formula preparation.  Do not use bottle water because it does not contain fluoride.

    Offer your baby lukewarm, boiled water in a nursing bottle once or twice daily, but not within an hour before the next feeding.  Some babies don't like water, and your baby may refuse it.  But its a good idea to offer it, especially during wthe warm weather when your baby may perspire more.  Do not give more than 1-2 ounces of water per day.  Use regular tap water since it contains flouride that is necessary to help prevent dental decay.

A Schedule with Flexibility
    Feeding schedules are usually most satisfactory if the hours are set roughly and the baby is allowed eat an hour before and an hour later than the scheduled time.  For example, if the bottle is due at six o'clock, feed anytime between five and seven o'clock.  Newborn babies usually need to be fed about every three hours and may often go four hours between feedings (with formula).  Should your baby occasionally wake up and cry less than two and a half hours after feeding he/she is probably not hungry.  However, should he/she consistently awaken and cry less than two and a half hours after feeding, the amount of formula may be insufficient.

How much Formula:
    The amount of formula your baby takes will vary.  Newborns have a right ot to be hungry somethimes, jas as your and I, and you can't make a baby want to eat.   Most babies feed for 15 or 20 minutes.  You will probably find that sometimes yor baby will take all of his/her bottle and sometimes he/she wont. Don't worry.  This is normal. As our baby takes all of his/her  bottle pretty regularly....and sometimes cries for more, it may be time to increase the amount of his/her daily formula.
It is important to recognize early feeding cues such as wiggling, moving their arms or legs and fussy squeaky noises.  A full cry is a late sign of readiness to feed.  There are a few different feeding positions. You should choose one that is most comfortable. Make sure you have plenty of pillows for support.

    Mom should guide her breast to assist her baby in taking the breast into his/her mouth and make sure your baby's nose is not pressed into the breast.  Feed yor baby from both breasts at each feeding.  Mom should drink to thirst and keep a glass of water nearby while feeding. Mom should maintain a well-balanced diet and drink plenty of water.

    If your are breast-feeding, supplement your baby with multivitamins.  Breast fed babies do not get enough vitamins thrrough breast milk. When you give your baby vitamin drops, point the opening of the dropper toward the cheek inside your baby's mouth, so that the drops do not fall too far back in its throat.
Feeding Time:
        Feeding is one your baby's first pleasant experiences.  The baby's first feeling of love for its mother arises primarily from the feeding situation.  At feeding time your baby receives nourishment from food and nourishment from mother's loving care.  Food, correctly taken helps them to grow healthy and strong.l Mother's love, generously given, helps your baby feel secure.

    Comfort is extremely important for your and your baby.  Choose a chair that is comfortable.  This will help you to be calm and relaxed as you feed your baby.  Your baby should be warm and dry so that he/she is comfortable too.

    Hold your baby in your lap, with his/her head slightly raised, and resting in the bend of your elbow when bottle feeding.  Whether breastfeeding or bottle feeding, hold your baby comfortably close.  Breast feeding? Please feel free to call Patty Iacovitti, our Lactation Consultant.

Breast Feeeding
     Breast milk is the most easily digested food for your baby.  It produces less gas and spitting up.  Breastfeeding has many advantages.  It's economical, provides a degree of immunity to some illnesses and importantly, you and your newborn are bonding.  Allow yourself and your baby time to learn the breastfeeding techniques.  Sometimes classes on breastfeeding taken during pregnancy are helpful.

     Babies are usually breastfed on demand.  Initially your baby will need between 8-12 feedings in a 24 hour period.  Try not to watch the clock.  The best timer is your baby.  Avoid pacifiers or supplemental feedings for the first two weeks. Learn to recognize ways your baby is getting enough milk.  For example listen to your baby swallowing and remember, your baby should have at least six soaking wet diapers in 24 hours.

Your baby should sleep on a firm, flat surface.   Do not let your baby sleep with fluffy things such as quilts, comforters, pillows, stuffed animals, etc.  Waterbeds are not safe.  Do not let your baby sleep with you.
Always use a car seat with the manufacturer’s recommended method of installation.   Wear seat belts yourself.  Second-hand car seats are not recommended.  Any car seat that is involved in a car accident should be replaced.
Safety/Car Seats
Summit Pediatrics-Where your child's good health is paramount.

We are available 24 hours a day, 7 days a week. We offer Urgent Care appointments on Saturdays

Immunizations are very important and shoud be started at 2 monthsof age.  Your baby should have immunizations to prevent whooping cough, diptheria, tetanus, polio, and hepatitis.  Hepatitis vaccine will be started in the nursery.