Physician’s Discharge Instructions for the Well Newborn

Feeding:
Breast feed on demand every 2-4 hours; Bottle feed on demand every 3-4 hours

Diapers:
Bowel movements vary- some infants stool with each feeding and others every few days. Stools may be runny, seedy, mushy, pasty, green, yellow or brown. Babies should be having at least six wet diapers in a 24 hour period by day four of life.

Care of the Penis:
A small amount of spotting from the circumcised penis is normal, healing usually occurs in 5-7 days. Apply a petroleum base ointment to the site with every diaper change until the skin looks normal. An uncircumcised penis requires no special care. Do not pull back foreskin.

Cord Care:
No special care required.

Temperature:
Routine temperature taking is not necessary. Check you baby’s temperature if he/she feels warm, cold or seems sick. Taking the temperature under the baby’s arm may be inaccurate, so obtain a rectal temperature.

Jaundice:
Check your baby’s skin from head to toe for a yellow color twice a day under the same lighting conditions.

Sleeping:
Place your infant on his/her back to sleep. Most newborns sleep a lot usually waking up every 2-4 hours for feeding. A certain amount of tummy time while the baby is awake and observed is recommended.

Crying:
Most newborns will have a few fussy periods.

Call your baby’s doctor for the following warning signs:

• Temperature is less than 97°F or greater than 100.4°F rectally. Do not give acetominphen (tylenol) for fevers during the first 6-8 weeks of age.
• Breathing is labored, distressed, or struggling to breathe.
• Difficulty waking up or refusing to eat for 2-3 feedings in a row.
• Excessive crying, irritability, or lethargy.
• Skin is more yellow than at time of discharge, or a blue or gray color.
• Vomiting for several feedings in a row or bloody or green vomit.
• Baby produces less than six wet diapers in a twenty-four hour period by four days of age.
• Bloody, black, or dark purple stools, large, frequent and watery.
• Redness around the umbilical cord, bleeding, foul odor or discharge.
• Bleeding or increasing redness of the penis

Post Partum Discharge Instructions

Medications:
Ibuprophen: 600 mg by mouth every 6-8 hours as needed for discomfort. Remember: Ibuprophen is preferrable to Percocet. Ibuprophen does not cause constipation, it is non-addictive, and there is no sedative effect to the baby. Some side effects may include headache, nausea, or vomiting. Percocet: 1-2 tablets by mouth every 3-4 hours as needed for moderate to severe pain. Prenatal Vitamins 1 tablet by mouth daily. Stool softner

IF THE FOLLOWING WARNING SIGNS OCCUR, CALL YOUR PHYSICIAN or MIDWIFE.

• Vaginal Bleeding: saturating the peripad which requires it to be changed more frequently than every 2-3 hours or the passing of large clots Remember it is to be anticipated that there will be increase bleeding while breastfeeding and with increased activity.
• Vaginal discharge: foul smelling
• Abdominal incision: red, swollen, draining or increasing discomfort.
• Episiotomy: increased discomfort, unusual discharge, or opening up of the stitches.
• Temperature: greater than 100.6ºF for 24 hours or longer.
• Urinating: burning or difficulty urinating or feeling that you are not completely emptying your bladder.
• Thigh/calf/breast: pain, redness and/or increased warmth.
• Emotions: prolonged, overwhelming feelings of helplessness, hopelessness, or an inability to cope.
• Headache: blurry vision, dizziness with or without a headache.

###